Summary & Overview
HCPCS J0350: Injection, Anistreplase, per 30 Units
HCPCS Level II code J0350 denotes the administration of anistreplase in 30-unit increments for thrombolytic therapy. As a hospital-administered therapeutic injection, this code is relevant to acute care workflows for treating occlusive thrombotic events and is used in billing for inpatient, emergency department, and specialized outpatient infusion services. Nationally, accurate use of this HCPCS code supports appropriate payment for high-acuity, time-sensitive interventions and ensures clinical documentation aligns with resource use for thrombolytic therapy.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain an understanding of the clinical context for J0350, typical sites of service, and payer coverage considerations. The publication outlines coding benchmarks, billing practice notes, and relevant policy and reimbursement updates that affect how J0350 is processed across major national payers. It also summarizes common modifier usage and areas where clinical documentation impacts claim adjudication. Where input data is missing, the report notes availability constraints.
Billing Code Overview
HCPCS Level II code J0350 describes Injection, anistreplase, per 30 units. This code represents the supply and administration of anistreplase, a thrombolytic agent used to dissolve blood clots in acute thrombotic events.
Service type: Therapeutic injection (thrombolytic therapy)
Typical site of service: Hospital inpatient or emergency department, and potentially outpatient infusion centers, where acute thrombolytic therapy is provided under close clinical supervision.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to the emergency department with acute onset chest pain and shortness of breath consistent with an acute ST-elevation myocardial infarction (STEMI). After rapid triage, ECG confirmation, and assessment of contraindications, the treating team elects pharmacologic thrombolysis because immediate percutaneous coronary intervention (PCI) is unavailable within recommended door-to-balloon time. The medication ordered is J0350 (anistreplase) dosed and billed per 30-unit increments. The medication is prepared by the hospital pharmacy and administered intravenously in the emergency department or cardiac care unit by an emergency medicine or cardiology nurse under physician supervision.
Typical workflow steps:
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Emergency presentation, rapid assessment, and ECG confirmation.
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Medication order entry for
J0350with dose calculated in 30-unit increments. -
Pharmacy verifies dose, prepares medication, and documents lot number and expiration.
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Nurse obtains informed consent when feasible and administers the IV bolus per protocol; continuous monitoring for reperfusion and bleeding follows.
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Post-administration care includes hemodynamic monitoring, repeat ECGs, serial cardiac biomarkers, and transfer to an intensive care or intermediate care bed as indicated.
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Billing is completed using
J0350per 30 units, with applicable modifiers to reflect circumstances such as unusual procedural services, complications, or provider status.