J2810 Theophylline Injection HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II J2810: Theophylline Injection, 40 mg

HCPCS Level II code J2810 denotes the theophylline injectable formulation, billed per 40 mg unit. The code is used when clinicians administer intravenous or intramuscular theophylline as a bronchodilator in acute or subacute respiratory care. Nationally, injectable theophylline remains a niche therapy compared with inhaled bronchodilators, but it retains clinical relevance for select patients who require systemic methylxanthine therapy.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of payment and coverage context across major payers, typical sites of service for billing, and clinical context that informs billing frequency. The publication summarizes benchmarks for utilization and reimbursement where available, highlights common billing considerations tied to unit-based reporting, and identifies gaps where data are not available in the input.

This summary equips billing managers, revenue cycle staff, and clinical leaders with a practical reference to the code’s clinical meaning, payer scope, and the types of operational questions to address when using J2810 in claims.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ2810HCPCS Level IItheophyllineinjectable medicationrespiratory therapymedication administrationoutpatient infusionhospital outpatient

Billing Code Overview

HCPCS Level II code J2810 represents an injection of theophylline, billed per 40 mg unit. The service corresponds to administration of a systemic bronchodilator medication used in respiratory care.

Service type: Injectable medication administration
Typical site of service: Outpatient infusion clinic, hospital outpatient department, emergency department, or other ambulatory care settings where injectable medications are administered

Clinical & Coding Specifications

Clinical Context

A patient in the outpatient infusion clinic requires parenteral theophylline because of inability to tolerate or absorb oral therapy and for rapid attainment of therapeutic serum levels. Typical patients include adults or adolescents with severe reversible airflow obstruction (for example, acute exacerbation of chronic obstructive pulmonary disease or asthma) who have compromised oral intake, persistent bronchospasm despite inhaled bronchodilators, or when enteral absorption is unreliable. The ordering clinician (pulmonologist, emergency physician, or hospitalist) writes an order for J2810 dosed per 40 mg increments; the pharmacy compounds or dispenses the injectable theophylline and documents concentration and total mg supplied. Nursing verifies patient identity, obtains baseline vital signs and relevant labs (serum theophylline level, electrolytes, renal and hepatic function), administers the injection or infusion per protocol, monitors for adverse effects (tachycardia, arrhythmia, nausea, seizures), and documents administration time, lot numbers, and site. If therapeutic drug monitoring is required, repeat serum levels are obtained and the dose adjusted. Billing uses J2810 with appropriate modifiers to indicate service details and any circumstances that affect reimbursement or reporting (for example, professional component, reduced services, or unrelated to primary care). Typical site of service is outpatient infusion center, hospital inpatient unit, emergency department, or observation unit depending on clinical acuity. Typical patient scenario: a 58-year-old with COPD exacerbation admitted from the ED with tachypnea and hypoxemia who cannot take oral medications; the ED physician orders IV theophylline to assist bronchodilation while inhaled therapies are optimized; pharmacy dispenses 200 mg (five units of J2810), nursing administers per protocol, and serum theophylline level is checked 6–8 hours post dose.

Coding Specifications

Related Codes

HCPCS-J2472-PANTOPRAZOLE-40MG-INJECTION

HCPCS J2472: Pantoprazole Sodium 40 mg Injection

HCPCS-J1644-HEPARIN-SODIUM-INJECTION-1000-UNITS

HCPCS J1644: Heparin Sodium Injection, per 1000 Units

HCPCS-J2425-PALIFERMIN-INJECTION-50-MCG

HCPCS J2425: Palifermin Injection, 50 micrograms

HCPCS-J3398-VORETIGENE-NEPARVOVEC-RZYL-1B-VECTOR-GENOMES

HCPCS J3398: Voretigene Neparvovec-Rzyl Injection, 1 Billion Vector Genomes

HCPCS-J0135-ADALIMUMAB-20MG-INJECTION

HCPCS Level II J0135: Adalimumab 20 mg Injection

HCPCS-J1120-ACETAZOLAMIDE-INJECTION-500MG

HCPCS Level II J1120: Injection, Acetazolamide Sodium, up to 500 mg

HCPCS-J0896-LUSPATERCEPT-INJECTION-025-MG

HCPCS J0896: Luspatercept-aamt Injection, 0.25 mg

HCPCS-J7622-BECLOMETHASONE-INHALATION-SOLUTION-UNIT-DOSE

HCPCS J7622: Beclomethasone Inhalation Solution, Compounded Unit Dose

HCPCS-J1552-IMMUNE-GLOBULIN-ALYGLO-500-MG-INJECTION

HCPCS Level II J1552: Immune Globulin (alyglo) 500 mg Injection

HCPCS-J0607-LANTHANUM-CARBONATE-ORAL-5MG-ESRD-DIALYSIS

HCPCS Level II J0607: Lanthanum Carbonate Oral 5 mg

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Taxonomy Code	Specialty	Notes
`207RP1000X`	Pulmonology	Pulmonologists order and manage theophylline for severe airway disease and oversee monitoring.
`208D00000X`	Emergency Medicine	Emergency physicians may order injectable theophylline for acute severe exacerbations when rapid bronchodilation is required.
`208000000X`	Hospitalist/Internal Medicine	Hospital-based physicians manage inpatient dosing, monitoring, and transitions from IV to oral therapy.
`363LP0800X`	Critical Care Medicine	Critical care physicians may direct IV theophylline administration in ICU patients with severe bronchospasm.
`363A00000X`	Anesthesiology	Anesthesiologists may be involved if unusual anesthesia or perioperative considerations affect dosing or administration.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J44.1`	Chronic obstructive pulmonary disease with (acute) exacerbation	IV theophylline may be used in severe COPD exacerbations when inhaled therapy is insufficient or oral route is not feasible.
`J45.902`	Unspecified asthma, uncomplicated, acute exacerbation	Injectable theophylline can be used as adjunctive bronchodilator therapy in severe asthma exacerbations in select cases.
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	In patients with respiratory failure who cannot take oral medications, IV theophylline may be considered as part of bronchodilator therapy.
`J98.01`	Acute bronchospasm	Theophylline's bronchodilator effect can be applied for acute bronchospasm not responding to inhaled agents.
`R06.02`	Shortness of breath, chronic	Used as a supportive diagnosis where intravenous theophylline is part of symptomatic management in severe cases.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used when IV theophylline is administered as an initial therapeutic infusion and time-based infusion reporting is required.
`96366`	Intravenous infusion, each additional hour	Used to report additional hours of continuous IV infusion beyond the initial hour when theophylline is infused continuously.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Used if injectable theophylline is administered intramuscularly or subcutaneously rather than intravenously, where payer allows.
`36415`	Collection of venous blood by venipuncture	Used when obtaining serum theophylline levels for therapeutic drug monitoring.
`99024`	Postoperative follow-up visit, after major surgery	May be used if postoperative medication management and monitoring include injectable theophylline as part of surgical care (use only when applicable).

`00`	No modifier; standard billing	Use when no special circumstance applies and the service is billed normally.
`11`	Professional component	Use when reporting only the physician's professional component related to the service, if applicable.
`22`	Increased procedural services	Use when the administration required substantially greater resources or time than typical (documented).
`23`	Unusual anesthesia	Use when the administration required general anesthesia or equivalent unusual anesthesia circumstances.
`52`	Reduced services	Use when the service was partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the administration was started but discontinued due to patient condition or other documented reason.
`54`	Surgical care only	Not commonly used for medication administration; include only if surgical team billed separately for surgical care.
`55`	Postoperative management only	Not commonly used; include only if separate postoperative management is reported.
`56`	Preoperative management only	Rare for this medication; use when only preoperative evaluation was provided.
`62`	Two surgeons	Use when two qualified clinicians from different specialties are jointly providing care that affects billing for the medication administration.
`78`	Unplanned return to OR	Not typically applicable to medication administration; use only if return to operating room affected the service.
`AS`	Physician assistant, in surgery	Use when a physician assistant provided the portion of care related to the procedure in accordance with payer rules.
`CO`	Unassigned	Jurisdictional or payer-specific modifier; use according to payer instruction when required.
`QK`	Medical direction of two, three, or four assistants	Use when the physician medically directed multiple assistants relevant to the service setting and payer allows.