J7131 HCPCS code: Hypertonic saline solution, 1 ml
J7131 is the HCPCS Level II code for hypertonic saline solution, 1 ml. In 2024 Medicare paid an average of $4.29 per service for J7131 across 260 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 500 per day on outpatient hospital claims. Medicare volume rose 62% from 2023 to 2024 (160 to 260 services). In 2024, about 23 clinicians billed Medicare for J7131 for 49 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2012-01-01 |
| Last action effective | 2012-01-01 |
Who bills J7131 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 23 |
| Medicare beneficiaries | 49 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7131, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 160 | 33 | $5.77 | $4.60 |
| 2024 | 260 | 49 | $5.38 | $4.29 |
States with the most J7131 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 76 | $0.09 |
| Florida | 22 | $21.49 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 500 | Prescribing Information |
| practitioner claims | 500 | Prescribing Information |
Medicare policy articles for this code
- A52466: Nebulizers - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (215 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A15.0 | Tuberculosis of lung | 1 |
| A22.1 | Pulmonary anthrax | 1 |
| A37.01 | Whooping cough due to Bordetella pertussis with pneumonia | 1 |
| A37.11 | Whooping cough due to Bordetella parapertussis with pneumonia | 1 |
| A37.81 | Whooping cough due to other Bordetella species with pneumonia | 1 |
| A37.91 | Whooping cough, unspecified species with pneumonia | 1 |
| A48.1 | Legionnaires' disease | 1 |
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
| B25.0 | Cytomegaloviral pneumonitis | 1 |
| B44.0 | Invasive pulmonary aspergillosis | 1 |
Showing 10 of 215. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J7131
- 2012-01-01: J7131 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J7131?
J7131 is the HCPCS Level II code for hypertonic saline solution, 1 ml. Short descriptor: "Hypertonic saline sol".
How much does Medicare pay for J7131?
In 2024, the average Medicare payment was $4.29 per service (average allowed $5.38).
Does Medicare cover J7131?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J7131?
Medicare policy articles that cite J7131 list 215 covered ICD-10-CM diagnosis codes across 1 article. The most cited include A15.0 (Tuberculosis of lung), A22.1 (Pulmonary anthrax), A37.01 (Whooping cough due to Bordetella pertussis with pneumonia). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J7131 can be billed per day?
500 on outpatient hospital claims; 500 on practitioner claims (NCCI medically unlikely edits).
Related J71 codes
- J7100 — Infusion, dextran 40, 500 ml
- J7110 — Infusion, dextran 75, 500 ml
- J7120 — Ringers lactate infusion, up to 1000 cc
- J7121 — 5% dextrose in lactated ringers infusion, up to 1000 cc
- J7165 — Injection, prothrombin complex concentrate, human-lans, per i.u. of factor ix activity
- J7168 — Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity
- J7169 — Injection, coagulation factor xa (recombinant), inactivated-zhzo (andexxa), 10 mg
- J7170 — Injection, emicizumab-kxwh, 0.5 mg
- J7171 — Injection, adamts13, recombinant-krhn, 10 iu
- J7172 — Injection, marstacimab-hncq, 0.5 mg
- J7173 — Injection, concizumab-mtci, 0.5 mg
- J7174 — Injection, fitusiran, 0.04 mg
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Next steps
- Run a reimbursement report for a device billed under J7131
- Watch J7131 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7131
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.