Summary & Overview
HCPCS J1446: Injection, tbo-filgrastim, 5 micrograms
HCPCS Level II code J1446 designates a 5 microgram dose of tbo-filgrastim, an injectable granulocyte colony-stimulating factor (G-CSF) used to support neutrophil recovery. Nationally, biologic supportive therapies such as tbo-filgrastim are important for reducing infection risk and enabling continuation of myelosuppressive cancer treatments and certain hematologic interventions. Coverage and billing practices for J1446 can affect access, site-of-care decision-making, and patient out-of-pocket costs.
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, typical sites of service (outpatient clinic, physician office, outpatient infusion center), and the role of tbo-filgrastim as an injectable biologic therapy. The publication summarizes payer coverage considerations, common billing relationships for HCPCS Level II injectables, and benchmark topics relevant to reimbursement policy and utilization management. Where specific payer policies or modifier use are not provided in the input, the text notes that data are not available.
This summary equips billing managers, practice administrators, and policy analysts with a national-level understanding of what HCPCS Level II code J1446 represents, why it matters for supportive oncology and hematology care, and which payers are central to coverage discussions.
Billing Code Overview
HCPCS Level II code J1446 represents an injection of tbo-filgrastim, 5 micrograms. This product is a granulocyte colony-stimulating factor (G-CSF) formulation used to stimulate neutrophil production.
Service type: injectable biologic therapy
Typical site of service: outpatient clinic, physician office, or outpatient infusion center
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient receiving J1446 is an adult or pediatric oncology patient requiring prophylaxis or treatment for chemotherapy-induced neutropenia. For example, a 58-year-old woman with stage II breast cancer who completed a cycle of myelosuppressive chemotherapy presents to the outpatient oncology infusion suite on day 3 post-chemotherapy. The oncologist orders a single subcutaneous injection of tbo-filgrastim 5 micrograms to stimulate neutrophil recovery. The clinical workflow includes verification of indication and weight-based dosing, informed consent, medication preparation by pharmacy, patient education on injection site care and potential adverse effects (bone pain, injection site redness), administration by an RN in the infusion clinic or by a home health nurse, documentation in the medical record, and billing using HCPCS level II code J1446 for the administered unit(s). Typical monitoring includes baseline and follow-up absolute neutrophil count (ANC) measurements and assessment for adverse events during subsequent clinic visits or phone follow-up by nursing staff.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure |