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J1885
HCPCS code J1885 identifies ketorolac tromethamine injection, reported per 15 mg for medically necessary treatment of short-term moderate to severe pain.
Code Description
HCPCS code J1885 is used to report ketorolac tromethamine, a nonsteroidal anti-inflammatory drug (NSAID) administered by injection for the short-term management of moderate to severe pain. The code is billed per 15 mg of the medication administered.
Ketorolac provides analgesic and anti-inflammatory effects and is commonly administered by intravenous or intramuscular injection when oral pain medication is not appropriate or sufficient. It is frequently used in emergency departments, outpatient surgery centers, physician offices, and hospital outpatient settings.
J1885 represents the medication only and does not include administration of the injection. When allowed by payer guidelines, the injection administration may be reported separately using the appropriate CPT® code.
When to Use
Report J1885 when ketorolac tromethamine is administered by injection for the medically necessary treatment of short-term pain and the dosage is documented.
The number of units billed should equal the total dose administered divided by 15 mg. For example, 30 mg equals 2 units, while 60 mg equals 4 units.
When NOT to Use
Do not report J1885 for oral ketorolac tablets or other non-injectable formulations.
Do not use this code for other injectable NSAIDs or pain medications that are described by different HCPCS codes. Do not bill more units than the amount of ketorolac actually administered.
Documentation Requirements
Documentation should support the medical necessity for ketorolac therapy and identify the diagnosis requiring treatment.
The medical record should include the medication administered, total dosage in milligrams, route of administration, date of service, and the healthcare professional administering the medication. Documentation should also support the number of billing units reported.
Documentation Checklist
✔ Medical necessity documented
✔ Diagnosis supports treatment
✔ Ketorolac tromethamine identified
✔ Total dosage documented in milligrams
✔ Route of administration documented
✔ Units billed accurately reflect the total dosage administered
Billing Examples
Emergency Department Pain Management
A patient receives 30 mg of ketorolac by intramuscular injection for acute flank pain. Report 2 units of J1885.
Office Administration
A patient receives 15 mg of ketorolac for acute musculoskeletal pain. Report 1 unit of J1885.
Hospital Outpatient Treatment
A patient receives 60 mg of ketorolac following an outpatient procedure for short-term pain management. Report 4 units of J1885.
Coding & Billing Tips
Bill one unit for every 15 mg administered.
Verify the medication matches the HCPCS code descriptor.
Document the exact dosage administered.
Report only the amount administered unless payer policy allows billing discarded drug amounts.
Report the appropriate injection administration CPT® code separately when permitted.
Review payer-specific billing guidelines before submitting claims.
Common Billing Mistakes
Billing the Wrong Number of Units
J1885 is billed per 15 mg of ketorolac tromethamine. The number of units reported should equal the total dosage administered divided by 15 mg. Billing an incorrect number of units may result in claim denials or payment adjustments.
Reporting J1885 for Oral Ketorolac
J1885 applies only to injectable ketorolac tromethamine. Oral ketorolac tablets are not reported with this HCPCS code.
Incomplete Medication Documentation
The medical record should identify the medication administered, dosage, route of administration, diagnosis, and medical necessity. Incomplete documentation may delay reimbursement or trigger payer audits.
Billing the Drug Without the Appropriate Administration Code
J1885 represents the medication only. When payer guidelines allow, the injection administration should be reported separately using the appropriate CPT® administration code.
Reporting Excess Dosage
Only bill the amount of ketorolac actually administered. The units reported should always match the documented dosage.
Applicable ICD-10-CM Diagnosis Codes
Diagnosis codes should accurately reflect the patient's documented condition and support medical necessity for ketorolac tromethamine administration. The following examples are common indications but are not an all-inclusive list.
M54.50 – Low Back Pain, Unspecified
This diagnosis code may support medical necessity when ketorolac is administered for the short-term treatment of acute low back pain.
Documentation should identify the patient's symptoms, clinical findings, and the reason injectable pain management was medically necessary.
N20.0 – Calculus of Kidney
This diagnosis code may support medical necessity when ketorolac is administered for acute pain associated with renal colic caused by kidney stones.
Documentation should clearly describe the diagnosis, severity of pain, and treatment provided.
G43.909 – Migraine, Unspecified, Not Intractable, Without Status Migrainosus
This diagnosis code may support medical necessity when ketorolac is administered to manage an acute migraine that requires injectable therapy.
Documentation should identify the patient's diagnosis, symptoms, and medical necessity for ketorolac administration.
Applicable Modifiers
Report Modifier JW when payer policy allows billing for the discarded amount of ketorolac from a single-dose container. Documentation should clearly identify the amount administered and the amount discarded.
Modifier JZ
Report Modifier JZ when no amount of ketorolac was discarded from a single-dose container, if required by payer policy. Documentation should support that the full contents were administered.
Report Modifier KX when payer policy requires confirmation that medical necessity or coverage requirements have been met. Documentation should demonstrate compliance with applicable payer guidelines.
Related HCPCS Codes
J1886
Injection, ketorolac tromethamine, per 30 mg (payer-specific or historical reference when applicable).
J3490
Unclassified drugs, used only when no specific HCPCS drug code accurately describes the medication administered.
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular administration.
Frequently Asked Questions
How are units calculated for J1885?
J1885 is billed per 15 mg. For example, a 30 mg injection is reported as 2 units, while a 60 mg injection is reported as 4 units.
Can J1885 be billed with an injection administration code?
Yes. J1885 represents the medication only. When payer guidelines permit, the appropriate CPT® code for administering the injection may also be reported.
Is J1885 used for chronic pain management?
No. Ketorolac is generally intended for the short-term management of moderate to severe acute pain and is not indicated for long-term use.
Can J1885 be reported in both office and hospital settings?
Yes. J1885 may be reported in physician offices, emergency departments, hospital outpatient departments, and other eligible healthcare settings when payer requirements are met.
What is the most common reason J1885 claims are denied?
Common denials occur when the billed units do not match the documented dosage, the medication is coded incorrectly, documentation is incomplete, or payer-specific billing requirements are not followed.
Category
HCPCS Level II
Common Setting
Billable Unit
Physician Offices, Hospital Outpatient Departments, Emergency Departments, Ambulatory Surgery Centers
Per 15 mg
Description
Code Type
HCPCS Code
J1885
Injection, ketorolac tromethamine, per 15 mg
Drugs Administered Other Than Oral Method
