Summary & Overview
HCPCS J2410: Oxymorphone Injection, Up to 1 mg
HCPCS Level II code J2410 denotes an injection of oxymorphone hydrochloride up to 1 mg, representing a short-acting parenteral opioid formulation used in acute pain management. Nationally, accurate coding and billing for opioid injections are important for clinical documentation, payer coverage determinations, and controlled-substance tracking. This code captures a distinct clinical product and dosage unit, which affects reimbursement, inventory management, and utilization monitoring.
Key payers in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise reference for how J2410 is classified, common sites of service where the injection is administered, and the contexts in which the code typically appears on claims. Readers will find benchmarks for clinical and billing contexts, a summary of relevant payer coverage considerations, and the clinical setting implications for ambulatory infusion, emergency department, and inpatient use. Where specific payer policy details or coverage rules are not available in the input, the report flags those elements as not provided.
This summary is intended as a national reference for coding leads, revenue cycle staff, and clinician administrators who need a clear description of the code and its practical relevance to claims processing and clinical workflows.
Billing Code Overview
HCPCS Level II code J2410 represents an injection of oxymorphone hydrochloride, dosed up to 1 mg per administration. This entry-level description indicates a single-dose parenteral opioid analgesic used for management of moderate to severe pain when oxymorphone injection is clinically indicated.
Service type: Injectable medication administration (parenteral opioid analgesic)
Typical site of service: Outpatient infusion/observation, ambulatory surgery centers, emergency departments, and inpatient acute care settings
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with moderate to severe acute pain presenting to an outpatient infusion center, emergency department, or ambulatory surgery center who has intolerance or inadequate analgesia with first-line opioids. The administered product is parenteral oxymorphone hydrochloride, billed as J2410 for doses up to 1 mg. Clinical workflow: initial assessment by a qualified prescriber (e.g., anesthesiologist, pain medicine specialist, emergency physician), review of allergies and prior opioid response, verification of indication and consent, preparation of the injectable medication by licensed pharmacy or trained clinical staff, and administration via intramuscular or intravenous injection in a monitored setting. Post-administration monitoring for respiratory depression, sedation, and hemodynamic stability occurs for an appropriate observation period; documentation includes medication name, dose, route, time, lot number, patient response, and any adverse events. Typical sites of service include an outpatient infusion suite, emergency department, ambulatory surgical center, or hospital inpatient unit.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient visit | When billing for an outpatient visit service associated with administration in a clinic setting |