{"id":174783,"date":"2026-08-10T13:47:27","date_gmt":"2026-08-10T13:47:27","guid":{"rendered":"https:\/\/pabau.com\/?p=174783"},"modified":"2026-08-17T12:07:55","modified_gmt":"2026-08-17T12:07:55","slug":"hcpcs-code-j0745","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/","title":{"rendered":"HCPCS code J0745: Codeine phosphate injection billing guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"HCPCS Code J0745: Codeine Phosphate Injection Billing Guide\",\"description\":\"Complete billing reference for HCPCS Code J0745 (Injection, codeine phosphate, per 30 mg). Covers unit calculation, Medicare fee schedule rates, covered ICD-10 diagnoses, NDC reporting, and claim submission steps.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j0745\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-08\",\"dateModified\":\"2026-08-08\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS code J0745 describes an injection of codeine phosphate, per 30 mg, and is used to bill Medicare and other payers for administered doses.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Units are calculated based on the total milligrams administered: a 60 mg dose equals 2 units of J0745.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>NDC number reporting is mandatory when billing J0745 to Medicare and Medicaid, and omitting it is a common cause of claim denial.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&rsquo;s claims management software helps practices track J-code units, NDC entries, and drug administration billing in one workflow.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">HCPCS code J0745 is the Level II code used to bill for an injection of codeine phosphate at a rate of per 30 mg. It belongs to the J-series of HCPCS Level II codes, which cover separately payable injectable and infused drugs administered in physician offices, outpatient hospital settings, and other clinical environments. According to the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/healthcare-common-procedure-system\" target=\"_blank\" rel=\"nofollow noopener\">Centers for Medicare and Medicaid Services (CMS)<\/a>, HCPCS Level II codes like J0745 are maintained annually and updated each January 1.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">J0745 carries a Permanent National status and is active for dates of service in the current fiscal year. It falls under Type of Service 1 (Medical Care), which determines how Medicare processes the claim. Before submitting any claim using this code, confirm the current-year status via the CMS HCPCS annual release file, as codes can be revised, replaced, or retired. Setting up medical forms at your practice to capture administered drug details at the point of care reduces the risk of coding errors downstream.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J0745<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official Descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, codeine phosphate, per 30 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code Type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Permanent National<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Active<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code Series<\/td>\n<td style=\"padding:12px 16px;color:#374151\">HCPCS Level II, J-series (injectable drugs)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Type of Service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1 (Medical Care)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Controlled Substance<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes (DEA Schedule II for codeine-only injectable formulations)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-code-description-and-billing-unit-calculation-for-j0745\" class=\"wp-block-heading\">Code description and billing unit calculation for J0745<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The unit definition in HCPCS Code J0745 is per 30 mg, meaning one unit equals 30 milligrams of codeine phosphate administered. This is where most billing errors occur. A prescriber administers 60 mg: the biller must submit 2 units. A 90 mg dose requires 3 units. Billing only 1 unit for a 60 mg dose results in underpayment; billing 2 units for a 30 mg dose risks a False Claims Act audit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Unit calculation formula:<\/strong> Divide the total milligrams administered by 30. Round to the nearest whole unit per CMS drug billing guidance. Never round up to inflate units, and document the administered dose in the patient chart to support the unit count on the claim. <\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Dose Administered<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Units to Bill (J0745)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Calculation<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">30 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">30 \u00f7 30 = 1<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">60 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">60 \u00f7 30 = 2<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">90 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">90 \u00f7 30 = 3<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">120 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">120 \u00f7 30 = 4<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-j0745-medicare-reimbursement-and-fee-schedule\" class=\"wp-block-heading\">J0745 medicare reimbursement and fee schedule<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimburses HCPCS code J0745 under the drug fee schedule as a separately payable drug under Medicare Part B when administered in an eligible outpatient setting. The payment rate is adjusted by the Geographic Practice Cost Index (GPCI), so what a clinic in rural Mississippi receives per unit differs from a clinic in urban California. Rates are updated annually on January 1 and should always be verified through the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule lookup tool<\/a> for your specific locality before making reimbursement projections.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">J0745 reimbursement also differs by place of service. Facility rates (hospitals, ambulatory surgical centers) are typically lower than non-facility rates (physician offices, clinics) because facility overhead is separately reimbursed to the institution. Coders must submit the correct Place of Service code to ensure the right rate applies. Mismatching the POS code with the actual setting is a frequent audit trigger.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Verify J0745 reimbursement rates quarterly using the CMS Medicare Physician Fee Schedule Search Tool. Filter by your MAC region and locality code to get the actual rate applicable to your clinic, not a national average.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-payer-coverage-and-prior-authorization-for-hcpcs-code-j0745\" class=\"wp-block-heading\">Payer coverage and prior authorization for HCPCS code J0745<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare Part B covers J0745 when codeine phosphate is administered by a provider in an outpatient clinical setting and a covered diagnosis supports medical necessity. Part D (the prescription drug benefit) generally covers oral formulations dispensed at a pharmacy, not injected drugs administered in a clinic. The distinction matters: billing Part D for an in-office injection will result in a coverage mismatch denial.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicaid coverage for J0745 varies by state. Most state Medicaid programs follow CMS guidance for J-series injectable drugs, but formulary restrictions and prior authorization requirements differ. Commercial payers handle codeine phosphate injections inconsistently. Many require prior authorization, especially given the controlled substance classification. Meeting med spa compliance requirements around controlled substance documentation helps support PA requests when needed.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Medicare Part B:<\/strong> Covers in-office and outpatient administered injections when medically necessary<\/li>\n\n\n\n<li><strong>Medicare Part D:<\/strong> Covers oral dispensed formulations, not in-office injections<\/li>\n\n\n\n<li><strong>Medicaid:<\/strong> Coverage varies by state; confirm with your state Medicaid formulary before billing<\/li>\n\n\n\n<li><strong>Commercial payers:<\/strong> Often require prior authorization; check payer policy before administration<\/li>\n\n\n\n<li><strong>Worker&rsquo;s Comp \/ Auto:<\/strong> Coverage and rate schedules vary by state jurisdiction<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Weight loss programs built on injectables run smoother in <a href=\"https:\/\/pabau.com\/industry\/weight-loss-clinic-software\/\">weight loss clinic software<\/a> that tracks doses week by week.<\/p>\n\n\n\n<h2 id=\"h-covered-icd-10-diagnosis-codes-for-j0745\" class=\"wp-block-heading\">Covered ICD-10 diagnosis codes for J0745<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity is the core documentation requirement for J0745 claims. The ICD-10 diagnosis code on the claim must directly support the use of an injectable opioid analgesic. Payers cross-reference the submitted diagnosis against their coverage policies and Local Coverage Determinations (LCDs). Maintaining thorough patient compliance documentation in the chart reduces the risk of a medical necessity denial on audit.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10 Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical Context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G89.18<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other acute postprocedural pain<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Post-surgical pain requiring parenteral opioid<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G89.29<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other chronic pain<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Chronic pain managed with injectable analgesics<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M54.5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Low back pain (note: retired in FY2023; use M54.50\/M54.51\/M54.59)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use the specific subcategory; M54.5 alone is no longer valid<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">R05.9<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cough, unspecified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Codeine&rsquo;s antitussive use; confirm payer coverage for this indication<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G89.11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Acute pain due to trauma<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Traumatic injury requiring parenteral pain management<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G89.3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Neoplasm related pain<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cancer-related pain management with opioid analgesics<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Always confirm the specific ICD-10 codes accepted by your payer&rsquo;s LCD before submitting. The table above represents commonly used diagnoses, not a comprehensive payer-approved list. Specificity matters: submitting G89.18 (Other acute postprocedural pain) rather than a generic pain code gives the claim more clinical context and reduces denial risk.<\/p>\n\n\n\n<h2 id=\"h-billing-guidelines-and-claim-submission-for-hcpcs-code-j0745\" class=\"wp-block-heading\">Billing guidelines and claim submission for HCPCS code J0745<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Correct claim submission for J0745 requires attention to several fields beyond the code and unit count. The Place of Service code, modifier selection, NDC number, and supporting diagnosis all need to be correct simultaneously. A single error in any one field can result in a denial even when the clinical documentation is complete. Practices that manage HIPAA requirements for med spas and outpatient clinics should build drug administration checklists into their billing workflows.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Select the correct Place of Service code:<\/strong> POS 11 for physician office, POS 22 for outpatient hospital. This determines your facility vs. non-facility rate.<\/li>\n\n\n\n<li><strong>Calculate and enter units:<\/strong> Total mg administered divided by 30. Enter as a whole number in the units field.<\/li>\n\n\n\n<li><strong>Report the NDC number:<\/strong> Mandatory for Medicare and Medicaid. Enter in the \u00ab\u00a0Shaded\u00a0\u00bb line of the CMS-1500 or the equivalent EDI loop (2410). Format: 5-4-2 segments with a qualifier of N4 and the unit of measure qualifier (UN for units, GR for grams, ML for milliliters, F2 for international units).<\/li>\n\n\n\n<li><strong>Attach the correct diagnosis code:<\/strong> The ICD-10 code must reflect the specific condition that required injectable codeine phosphate, with highest specificity available.<\/li>\n\n\n\n<li><strong>Apply modifiers as needed:<\/strong> See the modifier table below for context on which modifiers apply and when.<\/li>\n<\/ol>\n\n\n\n<h3 id=\"h-modifiers-used-with-j0745\" class=\"wp-block-heading\">Modifiers used with J0745<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier use with J0745 is payer-specific and setting-dependent. The table below covers the most commonly applied modifiers, but always verify with your specific payer&rsquo;s drug billing policy before adding a modifier to a J-code claim.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to Use<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">JA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Administered intravenously<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When codeine phosphate is given via IV route<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">JB<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Administered subcutaneously<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When codeine phosphate is given subcutaneously<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When J0745 is billed alongside another service on the same date and payer requires distinction<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">GY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Item\/service statutorily excluded<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When billing a non-covered indication to document denial for secondary payer or patient billing<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">KO<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Single drug unit dose formulation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required by some MACs when billing unit-dose injectable vials<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h3 id=\"h-national-drug-code-ndc-reporting-requirements\" class=\"wp-block-heading\">National Drug Code (NDC) reporting requirements<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">NDC reporting is not optional for J0745. CMS requires NDC submission for all separately payable drugs billed under Medicare Part B and Medicaid. The NDC identifies the exact manufacturer, product, and package size of the codeine phosphate vial used, which supports drug rebate reconciliation and fraud detection. Omitting the NDC or submitting an incorrect one results in an automatic claim denial from most MACs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The NDC must be the actual lot-traceable NDC from the vial administered, not the packaged kit NDC or a generic lookup value. Keep the drug packaging or pharmacy receipt on file to match the submitted NDC. Using prescription management software that captures NDC numbers at the point of administration reduces this risk significantly. For digital documentation workflows.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-j0745\/prescribe-controlled-drugs-safely-and-stay-compliant.webp\" alt=\"Prescribe controlled drugs safely and stay compliant\"\/><figcaption class=\"wp-element-caption\"><em>Prescribe controlled drugs safely and stay compliant<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">NDC format on claims: enter as 11 digits in 5-4-2 format (xxxxx-xxxx-xx) with the qualifier N4 in the appropriate field. Include the unit of measure and quantity administered. Reference HIPAA compliance standards for medical offices to ensure your drug administration documentation meets both CMS and security requirements.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Manage injectable drug billing in one place                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&rsquo;s claims management tools help practices track J-code units, capture NDC numbers at the point of service, and submit cleaner claims. See how it works for drug administration billing workflows.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard for injectable drug billing\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-related-hcpcs-j-codes-for-injectable-opioids-and-analgesics\" class=\"wp-block-heading\">Related HCPCS J-codes for injectable opioids and analgesics<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When codeine phosphate injection is not the right choice, or when a payer&rsquo;s formulary or LCD requires a different drug, coders need to know the related J-codes for injectable opioids and analgesics. Selecting the wrong J-code for the drug actually administered is a billing compliance violation. Practices managing IV therapy EMR software workflows often need to navigate multiple injectable drug codes simultaneously. See also the broader category of injectable drug billing codes for procedure-level context.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">HCPCS Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Drug \/ Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Unit<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J0745<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Codeine phosphate injection<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Per 30 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J2270<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, morphine sulfate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Per 10 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J2175<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, meperidine hydrochloride<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Per 100 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J1170<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, hydromorphone<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Up to 4 mg<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J3490<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unclassified drugs (catch-all when no specific J-code exists)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Variable<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J3010<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Injection, fentanyl citrate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Per 0.1 mg<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">J3490 (Unclassified drugs) is a billing option of last resort. Use it only when no specific J-code exists for the drug administered. Claims submitted under J3490 require an invoice and clinical justification attachment and are subject to greater payer scrutiny than claims under specific J-codes like J0745. Verify J-code accuracy using the <a href=\"https:\/\/www.aapc.com\/codes\/hcpcs-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC HCPCS Level II code reference<\/a> or <a href=\"https:\/\/www.pgmbilling.com\/hcpcs-lookup-tool\/\" target=\"_blank\" rel=\"nofollow noopener\">PGM Billing&rsquo;s HCPCS lookup tool<\/a>.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>When administering multiple opioid or analgesic injections in a single encounter, bill each drug under its own J-code with the correct unit count. Never combine two drugs into a single J-code line. Each has its own reimbursement rate and NDC number.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Related HCPCS codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j1885\/\">HCPCS code J1885 \u2014 Ketorolac<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j0775\/\">HCPCS code J0775<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j0878-daptomycin-injection-billing-guide\/\">HCPCS code J0878 \u2014 Daptomycin Injection, Per 1 mg<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j0894-2\/\">HCPCS code J0894<\/a><\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Billing errors on J0745 are rarely complex, but they are consistent: wrong unit counts, missing NDC numbers, and diagnosis codes that do not clearly support medical necessity. These are the three fields that need to be right every time, for every claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s claims management software helps practices that administer injectable drugs capture NDC numbers at the point of service, track administered units against prescribed doses, and submit cleaner claims without the manual lookups. To see how it handles drug administration billing workflows, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need help tracking IV therapy drug administration?<\/strong> <a href=\"https:\/\/pabau.com\/industry\/iv-therapy-emr-software\/\">IV therapy EMR software from Pabau<\/a> covers drug tracking, consent forms, and clinical notes in one platform.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Looking to go paperless on your drug admin forms?<\/strong> <a href=\"https:\/\/pabau.com\/features\/digital-forms\/\">Pabau&rsquo;s digital forms<\/a> capture NDC numbers and administered doses at the point of care, feeding directly into billing records.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Managing compliance around injectable drug billing?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/medspa-compliance\/\">Med spa compliance requirements<\/a> covers the documentation standards that apply to controlled substance administration records.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786352252902\"><h3 class=\"schema-faq-question\">What is HCPCS code J0745 used for?<\/h3> <p class=\"schema-faq-answer\">HCPCS code J0745 is a billing code used to report the administration of an injection of codeine phosphate at a rate of per 30 mg. It is submitted to Medicare, Medicaid, and commercial payers when codeine phosphate is administered by injection in a physician office, outpatient hospital, or other eligible clinical setting. It does not cover oral formulations or pharmacy-dispensed products.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786352252903\"><h3 class=\"schema-faq-question\">How many units is J0745 billed per dose?<\/h3> <p class=\"schema-faq-answer\">Units for J0745 are calculated by dividing the total milligrams administered by 30. A 60 mg dose equals 2 units; a 90 mg dose equals 3 units. Always document the administered dose in the patient chart to support the unit count on the claim.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786352252904\"><h3 class=\"schema-faq-question\">Is NDC reporting required when billing J0745 to Medicare?<\/h3> <p class=\"schema-faq-answer\">Yes. CMS requires NDC number reporting for all separately payable drugs billed to Medicare Part B and Medicaid, including J0745. Submit the NDC in 5-4-2 format with the N4 qualifier on the CMS-1500 or the EDI 837P loop 2410. Omitting the NDC results in an automatic claim denial from most Medicare Administrative Contractors.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786352252905\"><h3 class=\"schema-faq-question\">What ICD-10 codes are used with J0745?<\/h3> <p class=\"schema-faq-answer\">Common ICD-10 codes paired with J0745 include G89.18 (other acute postprocedural pain), G89.11 (acute pain due to trauma), G89.29 (other chronic pain), and G89.3 (neoplasm related pain). Always confirm which diagnosis codes your specific payer accepts under their Local Coverage Determination before submitting.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786352252906\"><h3 class=\"schema-faq-question\">How does J0745 differ from other opioid injection HCPCS codes?<\/h3> <p class=\"schema-faq-answer\">J0745 is specific to codeine phosphate at the per-30-mg unit rate. Other opioid J-codes cover different drugs with different unit definitions: J2270 covers morphine sulfate per 10 mg, J1170 covers hydromorphone up to 4 mg, and J3010 covers fentanyl citrate per 0.1 mg. Using the wrong J-code for the drug actually administered is a billing compliance violation, not just a denial risk.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786352252907\"><h3 class=\"schema-faq-question\">What modifiers are used with HCPCS code J0745?<\/h3> <p class=\"schema-faq-answer\">Modifier JA indicates intravenous administration; modifier JB indicates subcutaneous administration. Modifier 59 may be required when J0745 is billed alongside another service on the same date. Modifier GY is used when billing a non-covered indication to document denial for secondary payer purposes. Modifier requirements vary by payer, so confirm with your MAC or commercial payer&rsquo;s drug billing policy before applying.<\/p> <\/div> <\/div>\n\n\n","protected":false},"excerpt":{"rendered":"<p>HCPCS code J0745 is the Level II code used to bill for an injection of codeine phosphate at a rate of per 30 mg. It belongs to the J-series of HCPCS Level II codes, which cover separately payable injectable and infused drugs administered in physician offices, outpatient hospital settings, and other clinical environments. According to [&hellip;]<\/p>\n","protected":false},"author":82,"featured_media":174780,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"88","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1548],"tags":[],"class_list":["post-174783","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-hcpcs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.3 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>HCPCS code J0745: Codeine phosphate injection billing guide<\/title>\n<meta name=\"description\" content=\"HCPCS code J0745 is the Level II code used to bill for an injection of codeine phosphate at a rate of per 30 mg. 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Off the clock: binging true crime docuseries, baking and dreaming about travel.","url":"https:\/\/pabau.com\/fr\/blog\/author\/maja-popovska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252902","position":1,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252902","name":"What is HCPCS code J0745 used for?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"HCPCS code J0745 is a billing code used to report the administration of an injection of codeine phosphate at a rate of per 30 mg. It is submitted to Medicare, Medicaid, and commercial payers when codeine phosphate is administered by injection in a physician office, outpatient hospital, or other eligible clinical setting. It does not cover oral formulations or pharmacy-dispensed products.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252903","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252903","name":"How many units is J0745 billed per dose?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Units for J0745 are calculated by dividing the total milligrams administered by 30. A 60 mg dose equals 2 units; a 90 mg dose equals 3 units. Always document the administered dose in the patient chart to support the unit count on the claim.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252904","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252904","name":"Is NDC reporting required when billing J0745 to Medicare?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. CMS requires NDC number reporting for all separately payable drugs billed to Medicare Part B and Medicaid, including J0745. Submit the NDC in 5-4-2 format with the N4 qualifier on the CMS-1500 or the EDI 837P loop 2410. Omitting the NDC results in an automatic claim denial from most Medicare Administrative Contractors.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252905","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252905","name":"What ICD-10 codes are used with J0745?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Common ICD-10 codes paired with J0745 include G89.18 (other acute postprocedural pain), G89.11 (acute pain due to trauma), G89.29 (other chronic pain), and G89.3 (neoplasm related pain). Always confirm which diagnosis codes your specific payer accepts under their Local Coverage Determination before submitting.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252906","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252906","name":"How does J0745 differ from other opioid injection HCPCS codes?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"J0745 is specific to codeine phosphate at the per-30-mg unit rate. Other opioid J-codes cover different drugs with different unit definitions: J2270 covers morphine sulfate per 10 mg, J1170 covers hydromorphone up to 4 mg, and J3010 covers fentanyl citrate per 0.1 mg. Using the wrong J-code for the drug actually administered is a billing compliance violation, not just a denial risk.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252907","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/hcpcs-code-j0745\/#faq-question-1786352252907","name":"What modifiers are used with HCPCS code J0745?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Modifier JA indicates intravenous administration; modifier JB indicates subcutaneous administration. Modifier 59 may be required when J0745 is billed alongside another service on the same date. Modifier GY is used when billing a non-covered indication to document denial for secondary payer purposes. Modifier requirements vary by payer, so confirm with your MAC or commercial payer's drug billing policy before applying.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"HCPCS code J0745","seo_title":"HCPCS code J0745: Codeine phosphate injection billing guide","meta_description":"","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"j0745 fee schedule","score":61},{"keyword":"j0745 medicare reimbursement","score":61},{"keyword":"j0745 covered diagnoses","score":61},{"keyword":"j0745 icd 10","score":61},{"keyword":"injectable drug hcpcs codes","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/174783","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/comments?post=174783"}],"version-history":[{"count":3,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/174783\/revisions"}],"predecessor-version":[{"id":182773,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/174783\/revisions\/182773"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media\/174780"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media?parent=174783"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/categories?post=174783"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/tags?post=174783"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}