HCPCS J0365: Aprotinin Injection, 10,000 KIU

HCPCS Level II code J0365 represents an injectable formulation of aprotinin, 10,000 KIU, used as a systemic antifibrinolytic agent to reduce perioperative bleeding. Nationally, the code is relevant for hospitals and surgical centers that administer hemostatic pharmacotherapy during complex procedures. Proper coding ensures accurate capture of drug utilization and supports clinical documentation related to blood-loss management.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical role of aprotinin, common sites of service where the injection is administered, and the billing context for HCPCS Level II drug reporting. The publication provides benchmarks for utilization and payment where available, summarizes recent policy considerations affecting HCPCS drug coding and reimbursement, and situates the code within perioperative care pathways.

The content helps billing managers, hospital coders, and clinical pharmacists understand how HCPCS Level II code J0365 is used in claims reporting, what operational settings typically administer the drug, and which payers commonly process claims for this injectable hemostatic therapy. Data not available in the input.

Billing Code Overview

HCPCS Level II code J0365 describes an injection of aprotinin, dosed at 10,000 KIU. This entry represents a single-use pharmaceutical administration intended to provide the antifibrinolytic effects of aprotinin, typically used to reduce bleeding during certain surgical procedures.

Service type: Injectable hemostatic agent (intravenous administration)
Typical site of service: Hospital inpatient or outpatient surgical settings, including operating rooms and procedural suites where systemic antifibrinolytic therapy is provided

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Clinical Context

A 68-year-old male undergoing major cardiovascular surgery (e.g., coronary artery bypass grafting) receives intraoperative administration of aprotinin as an antifibrinolytic to reduce perioperative bleeding. The anesthesia team prepares a 10,000 KIU vial of aprotinin (J0365) for intravenous injection following induction of anesthesia and before incision. The medication is administered in the operating room by the anesthesia provider or perfusionist during cardiopulmonary bypass initiation, with vital sign and coagulation parameter monitoring. Postoperatively the patient is observed in the intensive care unit for bleeding, hemodynamic stability, and renal function, with documentation of dose, route, time, and clinical indication in the operative and anesthesia records.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when administration required substantially greater resources or effort than typical due to complications or unusual circumstances.
`23`	Unusual anesthesia	Use when anesthesia is administered for an otherwise non-anesthesia procedure or when anesthesia services are medically necessary and unusual.

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Anesthesiologists commonly manage intraoperative antifibrinolytic administration.
`2080P0207X`	Cardiothoracic Surgery	Cardiothoracic surgeons frequently direct use of aprotinin during cardiac surgery.
`1744S0105X`	Perfusionist	Perfusionists may administer or coordinate dosing during cardiopulmonary bypass.
`207RG0300X`	Critical Care Medicine	Intensivists manage postoperative monitoring and related medication effects.
`363L00000X`	Hematology	Hematologists provide consultation on coagulation management in high-risk bleeding cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I21.9`	Acute myocardial infarction, unspecified	Cardiac surgery following myocardial infarction where aprotinin may be used to reduce bleeding during revascularization.
`I50.9`	Heart failure, unspecified	Patients with advanced heart disease undergoing surgery with increased bleeding risk and hemodynamic instability.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	Indication for coronary artery bypass grafting where antifibrinolytics may be used intraoperatively.
`N17.9`	Acute kidney failure, unspecified	Renal dysfunction is a key postoperative risk to monitor when using aprotinin; preexisting or new renal injury affects drug use and monitoring.
`D69.5`	Secondary thrombocytopenia	Coagulopathy or platelet disorders that increase bleeding risk and may prompt antifibrinolytic use.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`00530`	Anesthesia for procedures on heart; open cardiac procedures	Anesthesia services provided during cardiac surgery when aprotinin is administered intraoperatively.
`33999`	Unlisted procedure, heart	Used for atypical or additional intraoperative hemostatic interventions related to bleeding control when no specific code exists.
`36556`	Insertion of non-tunneled centrally inserted central venous catheter	Central venous access often placed for medication administration and hemodynamic monitoring in major surgery.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance)	When billing for injection administration encounters separate reimbursement paths for injectable drugs in non-infusion settings.
`99291`	Critical care, evaluation and management of the critically ill or injured, first 30-74 minutes	Postoperative critical care for patients requiring intensive monitoring after administration and major surgery.

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Summary & Overview