J2351 Ocrelizumab Injection HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS J2351: Ocrelizumab with Hyaluronidase Injection, 1 mg

HCPCS Level II code J2351 denotes the injection of ocrelizumab, 1 mg, combined with hyaluronidase-ocsq. The code identifies a therapeutic biologic administration relevant to neurology and infusion therapy practices and is used in billing for outpatient infusion or clinic-based injectable services. Nationally, accurate coding for high-cost biologics such as ocrelizumab affects payer reimbursement, care coordination, and drug utilization tracking.

Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks and clarity on clinical context for use of this HCPCS Level II code, common billing considerations, and the typical sites where the service is provided. The publication outlines how J2351 is applied in billing lines, highlights common modifiers and payer reporting conventions (where available), and summarizes implications for billing workflows and claims processing. Data not available in the input is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ2351HCPCS Level IIocrelizumabbiologic injectioninfusionoutpatient clinicdrug administrationbilling

Billing Code Overview

HCPCS Level II code J2351 represents an injection of ocrelizumab, 1 mg, combined with hyaluronidase-ocsq. This code is used to report administration of the specified biologic agent preparation for infusion or injection therapy.

Service type: Therapeutic biologic injection
Typical site of service: Infusion center or outpatient clinic setting where injectable biologic therapies are administered

Clinical & Coding Specifications

Clinical Context

A patient with relapsing-remitting multiple sclerosis or primary progressive multiple sclerosis presents to an infusion center for administration of J2351 (injection, ocrelizumab, 1 mg and hyaluronidase-ocsq). The typical patient is an adult who has been evaluated by a neurologist and whose treatment plan specifies subcutaneous ocrelizumab combined with hyaluronidase to facilitate absorption. The clinical workflow includes pre-infusion screening (vital signs, review of prior infusion reactions, pregnancy testing where indicated, screening for active infections and hepatitis B), verification of consent and dosing, preparation of the medication by pharmacy, administration by an infusion or injection nurse, observation for infusion or injection-related reactions for the recommended post-administration period, and documentation of lot numbers, dose administered, site of injection, and any adverse reactions. Orders and documentation commonly include start/stop times, modifier reporting for billing, and coordination of future dosing intervals per the treating neurologist’s protocol.

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug discarded/not administered to any patient	Use when a portion of the single-use vial is discarded and must be reported for tracking of wasted drug cost.

HCPCS J1610: Injection, Glucagon Hydrochloride, per 1 mg

HCPCS-J2358-OLANZAPINE-LONG-ACTING-1MG-INJECTION

HCPCS J2358: Olanzapine Long-Acting Injection, 1 mg

HCPCS-J1455-FOSCARNET-INJECTION-1000MG

HCPCS J1455: Injection, foscarnet sodium, per 1000 mg

HCPCS-J7521-TACROLIMUS-GRANULES-ORAL-SUSPENSION-0-1MG

HCPCS J7521: Tacrolimus Granules, Oral Suspension, 0.1 mg

HCPCS-J2720-PROTAMINE-SULFATE-INJECTION-10MG

HCPCS J2720: Protamine Sulfate Injection, per 10 mg

HCPCS-J1212-DMSO-50-INJECTION-50ML

HCPCS J1212: Dimethyl Sulfoxide (DMSO) 50% Injection, 50 ml

HCPCS-J2783-RASBURICASE-INJECTION-0-5-MG

HCPCS J2783: Injection, rasburicase, 0.5 mg

HCPCS-J1599-INTRAVENOUS-IMMUNE-GLOBULIN-LIQUID-500MG

HCPCS J1599: Intravenous Immune Globulin, Liquid, 500 mg

HCPCS-J1164-DILTIAZEM-INJECTION-0-5-MG

HCPCS J1164: Diltiazem Hydrochloride Injection, 0.5 mg

HCPCS-J1300-ECULIZUMAB-INJECTION-10MG

HCPCS Level II J1300: Injection, eculizumab, 10 mg

Showing 1–10 of 991

Taxonomy Code	Specialty	Notes
`2084P0800X`	Neurology	Neurologists prescribe and manage disease-modifying therapy for multiple sclerosis, including ocrelizumab.
`363L00000X`	Infusion Therapy	Infusion center providers and dedicated infusion nurses administer parenteral therapies and supervise post-administration observation.
`364S00000X`	Nurse Practitioner	Nurse practitioners in neurology or infusion settings often perform counseling, injections, and documentation.
`207Q00000X`	Internal Medicine	Hospital-based internists or hospitalists may be involved when inpatient administration or complications require consultation.
`163W00000X`	Pharmacy	Clinical pharmacists prepare biologic agents, verify dosing, and manage medication safety and wastage documentation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G35`	Multiple sclerosis	Primary indication for ocrelizumab therapy; disease-modifying treatment to reduce relapse and progression.
`G36.0`	Neuromyelitis optica	Clinically relevant demyelinating disorder sometimes considered in differential diagnosis and treatment planning.
`D61.0`	Drug-induced aplastic anemia (not typical)	Included for vigilance regarding severe hematologic adverse events; monitor blood counts.
`B18.2`	Chronic viral hepatitis C	Chronic infections like hepatitis C affect eligibility and screening prior to immunotherapy.
`B18.1`	Chronic viral hepatitis B without delta-agent	Hepatitis B screening is required before B-cell depleting therapy due to reactivation risk.
`Z79.899`	Other long term (current) drug therapy	Used to indicate ongoing disease-modifying therapy when documenting chronic treatment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	Used when ocrelizumab is administered via intravenous infusion and infusion time is ≤1 hour; applicable in infusion workflows.
`96366`	Intravenous infusion; each additional hour (List separately in addition to code for primary service)	Used for extended infusion or monitoring time beyond the initial hour.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Used for subcutaneous administration of ocrelizumab when billed as an injection service rather than an infusion.
`36415`	Collection of venous blood by venipuncture	Performed for pre-infusion labs such as hepatitis B screening or pregnancy testing prior to therapy.
`99024`	Postoperative follow-up visit, included in global service (not usually listed for infusion)	Data not available in the input.

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