Summary & Overview
HCPCS J1602: Golimumab Injection, Intravenous, 1 mg
HCPCS Level II code J1602 denotes the unit dose for golimumab when administered intravenously (1 mg). Golimumab is a biologic agent used in clinical settings where IV delivery is required; accurate coding of J1602 is essential for billing, inventory tracking, and clinical documentation across hospital outpatient infusion centers and physician office infusion suites. Nationally, biologic infusion codes affect drug payment, prior authorization workflows, and patient cost-sharing, making precise coding important for clinicians and billing teams.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for golimumab IV administration, typical sites of service, common modifiers used with injectable drug codes, and guidance on what information is and is not available from the input. The publication outlines benchmarks and policy-relevant considerations such as payer coverage patterns, allowed billing modifiers, and coding practices that influence reimbursement and claims adjudication. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code J1602 indicates injection, golimumab, 1 mg, for intravenous use. This code represents the administration unit for the biologic therapy golimumab delivered via intravenous infusion.
Service Type: Intravenous infusion of a biologic medication
Typical Site of Service: Hospital outpatient infusion center or physician office infusion suite
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with moderately to severely active ulcerative colitis who has had inadequate response to or loss of response to conventional therapies presents to an infusion center for administration of intravenous golimumab. The patient arrives for an induction or maintenance infusion ordered by a gastroenterologist. Pre-infusion nursing assessment includes verification of identity, review of allergies, vital signs, and current medications. The infusion pharmacist verifies the physician order for J1602 (golimumab, 1 mg, IV), calculates the total dose based on the prescribed mg/kg or fixed dosing regimen, and prepares the product under aseptic technique. The infusion nurse obtains baseline vitals, establishes IV access, administers premedication if indicated (e.g., for prior infusion reactions), and initiates the IV infusion at the prescribed rate. During the infusion the nurse monitors for signs of hypersensitivity, infection, or infusion reactions and documents vital signs and any adverse events. After completion, the patient is observed per protocol, discharged with post-infusion instructions, and follow-up with the ordering gastroenterologist is arranged for efficacy assessment and ongoing monitoring for infections and immunogenicity. Billing uses J1602 for the drug administered; potential add-on billing includes infusion administration and monitoring codes as clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |