Summary & Overview
HCPCS Level II J0391: Injection, Artesunate, 1 mg
HCPCS Level II code J0391 denotes a 1 mg injectable dose of artesunate, an antimalarial medication used primarily for treatment of severe malaria. Nationally, accurate reporting of this code matters for hospital billing, inpatient drug utilization tracking, and public health surveillance of antimalarial therapy.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose and typical sites of service, payer coverage considerations, common billing modifiers, and benchmarks where available. The publication presents information useful for revenue cycle, pharmacy, and clinical teams, including coding context, potential policy implications, and references to related billing concepts.
This summary is written for a national audience and focuses on what the code represents, why it matters in clinical and billing workflows, and what topics are addressed in the full analysis: payer policies, utilization benchmarks, billing nuances, and clinical context surrounding artesunate administration.
Billing Code Overview
HCPCS Level II code J0391 represents injection, artesunate, 1 mg. This code is used to report administration of artesunate in an injectable form for antimalarial therapy. The service type is injectable medication administration, and the typical site of service is inpatient hospital or emergency department settings where intravenous antimalarial therapy is provided for severe malaria or related clinical indications.
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Clinical & Coding Specifications
Clinical Context
A patient presents to the emergency department or inpatient unit with suspected or confirmed severe falciparum malaria, or another severe parasitic infection for which parenteral artesunate is indicated. Typical presentation includes high-grade fever, rigors, altered mental status, hypotension, hemolysis, respiratory distress, or multi-organ dysfunction. Rapid diagnosis is supported by positive malaria smear or rapid diagnostic test. Intravenous artesunate (J0391, injection, artesunate, 1 mg) is administered as weight‑based dosing (commonly 2.4 mg/kg per dose for adults and children) at 0, 12, and 24 hours and then daily until oral therapy can be tolerated. The clinical workflow includes triage and stabilization, laboratory confirmation (CBC, metabolic panel, blood smear), weight measurement, preparation of artesunate by pharmacy, administration by nursing with monitoring for therapeutic response and adverse events (e.g., delayed hemolysis), documentation of dose, lot number, and any wasted product, and transition to oral antimalarial therapy (such as artemisinin-based combination therapy) once clinically appropriate. Typical site of service is the hospital inpatient unit or emergency department; use may also occur in outpatient infusion centers for urgent parenteral antimalarial therapy when clinically necessary. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
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