In short

J1130 is the HCPCS Level II code for injection, diclofenac sodium, 0.5 mg. One billing unit is 0.5 mg.

Code

CMS HCPCS file
HCPCS codeJ1130
Billing unit0.5 mg
Descriptor
Injection, diclofenac sodium, 0.5 mg
Short descriptor
Inj diclofenac sodium 0.5mg
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2019

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

Units and claim line

Units = dose given ÷ 0.5 mg. For example, 50 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Find the NDC

Med-Code hasn’t mapped J1130 to specific products yet. Search the FDA NDC Directory for the drug named in the descriptor, and check the route and strength match the code.

Search NDCs for diclofenac sodium

J1130: common questions

Is J1130 a CPT code?
No. J1130 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 J1130?
One unit of J1130 is 0.5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.5 mg. J-code billing units.

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