Summary & Overview
HCPCS J0882: Darbepoetin Alfa Injection, 1 mcg (ESRD on Dialysis)
HCPCS Level II code J0882 denotes the administration of darbepoetin alfa, 1 microgram, for patients with end-stage renal disease on dialysis. This biologic injection is a key component of anemia management in the dialysis population and has national relevance because it affects clinical protocols, outpatient dialysis workflows, and payer coverage decisions across public and private plans. Key payers typically included in coverage discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what J0882 represents clinically and operationally, plus what to expect in payer coverage and billing practice. The publication covers benchmark pricing and utilization context where available, relevant payer policy themes, and coding considerations specific to injectable biologic administration in dialysis settings. It also summarizes common billing modifiers and service line implications when data is available. Data not available in the input is noted explicitly where applicable. The focus is national policy and billing context rather than state-specific rules or provider recommendations.
Billing Code Overview
HCPCS Level II code J0882 represents an injection of darbepoetin alfa, 1 microgram, intended for treatment of patients with end-stage renal disease (ESRD) on dialysis. The service type is therapeutic injectable biologic administered to manage anemia associated with chronic kidney disease in the dialysis population. The typical site of service is outpatient dialysis centers or hospital outpatient infusion clinics, where patients receive routine dialysis and associated injectable therapies.
Clinical & Coding Specifications
Clinical Context
A common scenario for J0882 involves a 58-year-old patient with end-stage renal disease (ESRD) receiving maintenance hemodialysis three times weekly at an outpatient dialysis center. The patient has documented anemia of chronic kidney disease with hemoglobin persistently below target despite iron repletion. The dialysis clinic nurse prepares and administers an intravenous dose of darbepoetin alfa during a dialysis session per the nephrologist’s orders. The clinical workflow includes: review of most recent hemoglobin, review of iron studies, verification of physician order for darbepoetin alfa dose (expressed in micrograms), medication preparation per facility protocol, documentation of lot number and dose administered, monitoring for immediate adverse reactions during and after administration, and updating the patient’s dialysis and medication records. Billing is submitted using HCPCS Level II code J0882 (injection, darbepoetin alfa, 1 microgram) with the appropriate modifier to reflect service circumstances and the dialysis facility’s claim type. Typical site of service is an outpatient hospital-based or free-standing dialysis center. Typical patient scenario: ESRD patient on chronic hemodialysis receiving intravenous erythropoiesis-stimulating agent therapy to manage anemia associated with renal failure.
Coding Specifications
| Modifier | Description | When to Use |
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