Summary & Overview
HCPCS Level II J2787: Riboflavin 5'-phosphate Ophthalmic Solution, up to 3 ml
HCPCS Level II code J2787 identifies riboflavin 5'-phosphate ophthalmic solution in a volume up to 3 ml. This code is used to bill for the ophthalmic pharmaceutical product itself when dispensed or administered in clinical settings. The code matters nationally as new ophthalmic therapeutics and corneal cross-linking adjuncts have increased utilization of specialty ophthalmic agents, making accurate coding important for clinical documentation and payer communications.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks for payer coverage patterns where available, notes on common billing modifiers, and clinical context describing typical service lines and sites of care. The summary highlights how the code is applied in ambulatory ophthalmology clinics and outpatient specialty centers for procedures or treatments requiring topical riboflavin preparations.
This publication provides a national-level reference for coding staff, revenue cycle teams, and clinical administrators on the purpose and use of J2787, expected service settings, and what elements to verify with payers. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J2787 describes Riboflavin 5'-phosphate, ophthalmic solution, up to 3 ml. The service represents delivery or administration of a topical ophthalmic pharmaceutical formulation containing riboflavin 5'-phosphate intended for use in the eye.
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Service type: Ophthalmic pharmaceutical administration/dispensing
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Typical site of service: Ambulatory ophthalmology clinic, hospital outpatient department, or specialty eye treatment center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an ophthalmology clinic with progressive keratoconus or documented corneal ectasia after refractive surgery, being evaluated for corneal collagen cross-linking (CXL). The ophthalmologist confirms progressive stromal thinning, increasing myopic shift, or worsening irregular astigmatism on serial topography and pachymetry. After informed consent and pre-procedure assessment, the patient receives a topical anesthetic and epithelial management per protocol (epithelium-off or transepithelial). J2787 (riboflavin 5'-phosphate, ophthalmic solution) is instilled on the cornea in measured aliquots (up to 3 ml) as the photosensitizer prior to ultraviolet-A irradiation. The product is supplied and billed as a separately payable drug when dispensed by the facility or provider.
Typical workflow:
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Pre-procedure evaluation with slit-lamp exam, corneal topography, pachymetry, and documentation of progression.
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Procedure room preparation: topical anesthesia, antisepsis, and riboflavin instillation per manufacturer and clinical protocol.
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Delivery of ultraviolet-A (UVA) light source for cross-linking after adequate stromal riboflavin saturation is confirmed.
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Post-procedure care: antibiotic and anti-inflammatory topical drops, follow-up visits for epithelial healing, and serial topography to monitor effect.
Coding Specifications
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