Summary & Overview
HCPCS J1307: Crovalimab-akkz Injection, 10 mg
HCPCS Level II code J1307 designates a 10 mg unit of crovalimab-akkz for injection, a parenteral biologic medication used in specialty therapeutic settings. Nationally, correctly billing biologic injections is important for clinical documentation, payer reimbursement, and tracking utilization of high-cost specialty drugs.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what J1307 represents, the typical service settings for administration, and the scope of payers commonly handling claims for this product. The publication outlines benchmarks and billing considerations relevant to injectable biologics, summarizes common modifier usage patterns, and highlights the clinical context in which crovalimab-akkz is administered.
This summary provides clinicians, billing professionals, and policy analysts with a clear reference on coding and payer context for J1307, plus notes on where to look for policy updates and reimbursement benchmarks. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J1307 represents Injection, crovalimab-akkz, 10 mg. This code is used for billing a single 10 mg administration of crovalimab-akkz, a parenteral biologic therapy administered by injection. The service type is an injectable biologic medication intended for intravenous or subcutaneous administration depending on clinical protocol. The typical site of service for this drug is outpatient infusion centers, hospital outpatient departments, physician offices, or other clinical settings where parenteral biologic therapies are administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a complement-mediated hemolytic disorder or other rare hematologic condition for which crovalimab is indicated. The patient arrives at an outpatient infusion center or specialty clinic for administration of J1307 (injection, crovalimab-akkz, 10 mg). Prior to administration, the infusion nurse verifies identity, reviews recent laboratory results (CBC, hemolysis markers), confirms previously obtained baseline screening for infectious risk and vaccination status, and reviews prior dosing and infusion reactions. The medication is prepared by pharmacy according to weight-based or fixed dosing guidelines and delivered to the infusion area. The nurse documents pre-medications if given (e.g., acetaminophen, antihistamine), applies appropriate venous access (peripheral IV or existing port), and administers the injection/infusion per product-specific rate and monitoring parameters. Vital signs are recorded baseline, during, and post-administration. Observation time varies based on prior reaction history; rescue medications and emergency equipment are immediately available. Post-administration documentation includes lot number, amount administered (mg), route, site, any modifiers applied, and any adverse events. Billing is submitted using J1307 with applicable modifiers and a corresponding ICD-10 diagnosis that justifies therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |