J0911 Taurolidine-Heparin (HCPCS) Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II J0911: Taurolidine-Heparin Catheter Lock for Hemodialysis

HCPCS Level II code J0911 represents the instillation of taurolidine 1.35 mg combined with heparin sodium 100 units used as a central venous catheter lock for adult patients receiving chronic hemodialysis. This code identifies a specialized vascular access maintenance procedure that supports catheter patency and infection prevention, making it relevant to dialysis providers, outpatient infusion centers, and payers managing chronic renal replacement therapy populations nationwide. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, benchmarking considerations for reimbursement and utilization, common billing modifiers and coding practice notes, and relevant payer policy highlights where available. The publication also outlines documentation elements and potential audit focal points for claims involving catheter lock solutions. Data not available in the input is noted where applicable; this summary focuses on nationally applicable implications rather than state-specific rules.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ0911HCPCS Level IIcatheter lockhemodialysistaurolidineheparinvascular accessoutpatient dialysisinfusion services

Billing Code Overview

HCPCS Level II code J0911 describes the instillation of taurolidine 1.35 mg and heparin sodium 100 units as a central venous catheter lock intended for adult patients receiving chronic hemodialysis. The service type is a catheter lock instillation used to maintain catheter patency and reduce infection risk in long-term hemodialysis access. The typical site of service is an outpatient dialysis center or other ambulatory setting where chronic hemodialysis is administered.

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with end-stage renal disease (ESRD) receiving chronic hemodialysis presents to the outpatient dialysis center for a scheduled hemodialysis session. The patient has a tunneled central venous dialysis catheter that is routinely locked between treatments to maintain catheter patency and reduce the risk of catheter-related bloodstream infection. Prior to connecting the dialysis circuit, the dialysis nurse aspirates residual lock solution, inspects the catheter exit site, performs standard line disinfection, and then instills a catheter lock consisting of taurolidine 1.35 mg combined with heparin sodium 100 units into each lumen according to facility protocol. Documentation includes catheter type, volumes instilled, lot numbers for drugs used, patient tolerance, and the clinical indication for catheter lock therapy (chronic hemodialysis via central venous catheter). Typical site of service is an outpatient dialysis center or hospital-based dialysis unit. Service type is a medication instillation/catheter lock performed as part of routine maintenance of a central venous dialysis catheter for adult chronic hemodialysis patients.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier.	Use when no special reporting modifier applies.

HCPCS J1411: Injection of etranacogene dezaparvovec-drlb, therapeutic dose

HCPCS-J7640-FORMOTEROL-INHALATION-UNIT-DOSE-THROUGH-DME

HCPCS J7640: Formoterol Inhalation Solution, Unit Dose via DME

HCPCS-J2930-METHYLPREDNISOLONE-INJECTION-UP-TO-125-MG

HCPCS J2930: Methylprednisolone Injection, Up to 125 mg

HCPCS-J2780-RANITIDINE-INJECTION-25MG

HCPCS Level II J2780: Injection of Ranitidine Hydrochloride, 25 mg

HCPCS-J8610-METHOTREXATE-ORAL-2-5-MG

HCPCS Level II J8610: Methotrexate, Oral, 2.5 mg

HCPCS-J0610-CALCIUM-GLUCONATE-INJECTION-10ML

HCPCS Level II J0610: Injection, Calcium Gluconate 10 ml

HCPCS-J3105-TERBUTALINE-INJECTION-UP-TO-1MG

HCPCS Level II J3105: Terbutaline Sulfate Injection, Up to 1 mg

HCPCS-J1453-FOSAPREPITANT-INJECTION-1MG

HCPCS J1453: Fosaprepitant Injection, 1 mg

HCPCS-J0270-ALPROSTADIL-INJECTION-1-25-MCG-OFFICE-ADMINISTERED

HCPCS J0270: Alprostadil Injection, 1.25 mcg

HCPCS-J0630-CALCITONIN-SALMON-INJECTION-UP-TO-400-UNITS

HCPCS Level II J0630: Injection, Calcitonin Salmon, up to 400 Units

Showing 1–10 of 991

Taxonomy Code	Specialty	Notes
`363A00000X`	Nephrology	Primary specialty managing chronic hemodialysis patients and catheter care protocols.
`174400000X`	Dialysis Technician	Staff who typically perform catheter lock instillation under nursing supervision in outpatient dialysis centers.
`207RN0401X`	Registered Nurse	Nurses who perform catheter care, instillation, and documentation during dialysis sessions.
`363L00000X`	Vascular Surgery	Specialty involved when catheter placement, exchange, or surgical intervention is required.
`207R00000X`	Physician Assistant	Clinicians who may perform or supervise catheter management under physician oversight.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for chronic hemodialysis and the presence of a tunneled central venous catheter requiring lock therapy.
`T82.7XXA`	Infection and inflammatory reaction due to other vascular prosthetic devices, implants and grafts, initial encounter	Relevant when catheter-related infection is suspected and catheter lock therapy may be used as part of management or prevention strategies.
`I82.409`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Represents thrombotic complications that relate to catheter patency issues; catheter locks with anticoagulant (heparin) are used to prevent lumen thrombosis.
`T80.213A`	Infection following infusion, transfusion and therapeutic injection, initial encounter	Relevant when infection related to catheter instillation is a concern or complication.
`Z99.2`	Dependence on renal dialysis	Administrative code often used to indicate chronic dialysis dependence and justify ongoing catheter maintenance procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36556`	Insertion of tunneled centrally inserted central venous catheter, with subcutaneous port or pump, with imaging and subcutaneous tunneling.	Performed when placing a tunneled dialysis catheter prior to routine catheter lock maintenance; related as the initial access procedure.
`36561`	Replacement, complete, of tunneled central venous catheter, without subcutaneous port or pump, requiring cutdown, when performed.	Performed when a dialysis catheter requires exchange; catheter lock instillation is subsequent maintenance care.
`36593`	Injection procedure for central venous catheter, infusion, or flushing; each catheter lumen (separate procedure).	Relevant for billing flushing or instillation services of catheter lumens; used when documenting medication instillation or flush volumes per lumen.
`36415`	Collection of venous blood by venipuncture.	Often performed in the same visit for routine labs associated with dialysis care and to assess infection or anticoagulation status.
`99070`	Supplies and materials (e.g., syringes, sterile dressings), used for patient care not included in other services.	Used to report additional non-drug supplies associated with catheter lock instillation and maintenance.

OpenPayer