Summary & Overview
HCPCS Level II J1807: Ethacrynate Sodium Injection, 1 mg
HCPCS Level II code J1807 designates an injectable dose of ethacrynate sodium packaged and billed per 1 mg. As a drug administration code, it is relevant for billing of parenteral therapies delivered in outpatient settings, physician offices, and hospital outpatient departments. Nationally, accurate identification and use of this HCPCS Level II code supports consistent drug reimbursement, inventory tracking, and clinical documentation for patients receiving this specific intravenous or intramuscular treatment.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical scope and service context, plus what to expect from payer coverage patterns and administrative considerations. The publication outlines typical benchmarks, common billing modifiers and claims practices, and the clinical context surrounding use of ethacrynate sodium.
This briefing is intended for national audiences involved in revenue cycle, clinical operations, and payer contracting. It highlights the code’s purpose, typical sites of service, payer coverage landscape, and the practical items to monitor when billing for J1807. Data not available in the input.
Billing Code Overview
HCPCS Level II code J1807 represents an injectable formulation of ethacrynate sodium, billed per 1 mg unit. This code describes a parenteral therapeutic medication administered by injection. The service type is an injectable drug administration and the typical site of service is an outpatient clinic, physician office, or hospital outpatient department where parenteral therapies are given.
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Clinical & Coding Specifications
Clinical Context
A 68-year-old male with chronic refractory ascites secondary to portal hypertension is evaluated in the outpatient hepatology infusion suite for intraperitoneal sclerosis therapy. The clinician orders intraperitoneal injection of ethacrynate sodium (J1807, 1 mg) to promote sclerosis of peritoneal surfaces after diagnostic paracentesis confirmed recurrent symptomatic fluid accumulation. The patient is prepped in a dedicated procedure room or infusion clinic; informed consent and review of allergies and anticoagulation status are completed. Vital signs and baseline labs (including coagulation profile) are reviewed. Under sterile technique, the provider administers the J1807 injection via the established paracentesis catheter or after placement of a small-bore catheter. The patient is observed for immediate adverse reactions for 30–60 minutes, discharged with post-procedure instructions, and scheduled for follow-up to assess symptom control and need for repeat therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no modifier is applicable and reporting requires a two-character modifier field as blanks are not accepted. |