HCPCS Code J1815: Injection, Insulin, Per 5 Units

Learn about the HCPCS J1815 for injection, insulin, per 5 units through this short guide, including code description, billing and more.

Use Code

## **What is the HCPCS code J1815 for?** The HCPCS code J1815 is a code for designating the injection of insulin into a patient, specifically for every 5 units. These 5 units of insulin (insulin lispro or regular insulin) are administered subcutaneously through an insulin pump. The purpose of this injection is to manage and regulate the blood glucose levels in diabetics. If you're going to administer this shot to patients, please inform them that they should monitor their blood sugar levels before the shot so you can determine the necessary dosage for the patient. Please note that this code can be used if you or another healthcare professional administered the injection. It can also be used if it's self-administered by the patient.

## **Documentation requirements for J1815** As with any procedure, especially involving injecting drugs into patients, it's important to document the following before you file for a claim that includes this code: - The full name of the personnel who administered the injection + their credentials - The name and address of the facility where the injection was administered - The full name of the patient - The dates and times of the administration by injection - Patient records showing their diabetes diagnosis and related conditions and symptoms - Records of insulin products that the patient uses - Records of their blood glucose levels - The exact dosage(s) of the insulin shots

## **Billing requirements for J1815** Besides the documentation requirements above, please note the following billing requirements for this HCPCS code: - They must reflect the dosage given over the course of the treatment. - Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication. You must also use the CPT code 96372 since this injection is injected intramuscularly/subcutaneously. Please follow the guidelines of CMS, Medicare administrative contractors, or Medicaid services to prevent claim rejections.

## **Other similar codes** - J1815 - Injection, insulin, per 5 units - J1817 - Insulin for administration through dme (i.e., insulin pump) per 50 units - J3310 - Injection, perphenazine, up to 5 mg - J0586 - Injection, abobotulinumtoxina, 5 units - J2357 - Injection, omalizumab, 5 mg

Frequently asked questions

It can be performed in a hospital, an outpatient clinic, or at home.

As with any injection, there will be pain and discomfort in the injection site. Adverse reactions include bruising, injection site infection (please use antiseptics before injecting the insulin to prevent this), allergic reactions, and hypoglycemia.

FDA-approved Oral anti-diabetic medication is a good alternative, but this will vary from patient to patient. It should only be an alternative if you can confirm that it suits the patient you're handling. It's also good to pair insulin shots or oral anti-diabetic medication with proposed lifestyle changes to maximize the benefits.