HCPCS Level II › J codes J7131 Hypertonic saline solHypertonic saline solution, 1 ml
Medicare coverage: Special coverage instructions apply Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 500 units per day (clinical), rationale: Prescribing Information Outpatient hospital: max 500 units per day (clinical), rationale: Prescribing Information DME supplier: max 0 units per day (clinical), rationale: CMS Policy Medicare pricing for J7131 Physician Fee Schedule (CY 2026, RVU26D) Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J7131 Payer coverage policies that name J7131 J7131 appears in 2 coverage policies from Blue Shield of California, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
Payer Policy Role in policy Reviewed Document Blue Shield of California BSC8.05 | Lysis of Epidural Adhesions listed, no stance payer document Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) Lysis of Epidural Adhesions (SUR712.024) listed, no stance Apr 15, 2026 payer document
Medicaid fee-for-service AZ: $0.18 (outpatient_hospital), effective Apr 1, 2026 IN: $0.01 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2012 KS: $0.17 (default), effective Apr 1, 2026 KY: $0.00 (asc), effective Jan 1, 2026 MS: $0.16 (comprehensive), effective Jul 1, 2026 NE: $0.19 (injectables), effective Jul 1, 2026 OK: $0.08 (physician, non-facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $0.01 (professional_administered_drugs), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.