In short

J1097 is the HCPCS Level II code for phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml. One billing unit is 1 ml.

Code

CMS HCPCS file
HCPCS codeJ1097
Billing unit1 ml
Descriptor
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
Short descriptor
Phenylep ketorolac opth soln
Code set
HCPCS Level II, maintained by CMS
Effective
Oct 1, 2019

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Units and claim line

Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the units to build the claim line.

J1097: common questions

Is J1097 a CPT code?
No. J1097 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What is one billing unit of J1097?
One unit of J1097 is 1 ml, as stated in the code's descriptor. Units to report = dose given ÷ 1 ml. J-code billing units.

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