Summary & Overview
HCPCS J2267: Injection, mirikizumab-mrkz, 1 mg
HCPCS Level II code J2267 designates the injectable biologic mirikizumab-mrkz, billed per 1 mg unit. As a drug-specific HCPCS Level II code for a parenteral monoclonal antibody, it is important for claims processing, medical benefit billing, and pharmacy/infusion cost management across outpatient and clinic settings. Nationally, accurate use of J2267 affects drug utilization tracking, prior authorization workflows, and spend reporting for high-cost biologic therapies.
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 code's clinical context and service setting, plus operational details relevant to billing teams: common payer coverage considerations, typical sites of service, and common modifiers used with HCPCS drug codes. The publication summarizes benchmarks and policy-relevant items where available and flags that detailed payer-specific coverage determinations and pricing data are payer-controlled. Data not available in the input will be explicitly noted where applicable.
This resource is intended for coding specialists, revenue cycle staff, pharmacy and infusion program managers, and policy analysts seeking a clear national reference on HCPCS Level II code J2267 for mirikizumab-mrkz administration and billing.
Billing Code Overview
HCPCS Level II code J2267 represents an injectable biologic product described as Injection, mirikizumab-mrkz, 1 mg. The code denotes the medication unit for mirikizumab-mrkz supplied as an injection.
Service type: Drug administration via injection.
Typical site of service: Outpatient infusion/injection setting or clinic administration, including physician offices and infusion centers, where parenteral biologic therapies are administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28–55-year-old adult with moderate to severe plaque psoriasis or active ulcerative colitis who has been prescribed subcutaneous biologic therapy with mirikizumab-mrkz. The patient presents to an outpatient infusion/ injection clinic, ambulatory surgery center, or physician office for administration of the prescribed dose. The clinician—commonly a dermatologist, gastroenterologist, or registered nurse—verifies the medication order, performs a pre-injection assessment (including allergies, recent infections, and pregnancy status), documents baseline vital signs, and prepares the prefilled syringe or vial containing mirikizumab-mrkz. The medication is administered subcutaneously; the injection site is observed for immediate adverse reaction for 15–30 minutes per clinic protocol. Post-administration documentation includes lot number, NDC when available, date/time, route, dose in mg, administering provider taxonomy, and any patient education provided regarding delayed adverse effects and follow-up dosing schedule. Billing uses the HCPCS Level II code J2267 reported per milligram of mirikizumab-mrkz administered, with appropriate modifier(s) to reflect circumstances such as split/shared services, billing for discarded drug, or unrelated services during the same encounter.
Coding Specifications
| Modifier | Description | When to Use |
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