Summary & Overview
HCPCS J2724: Injection, Human Protein C Concentrate, 10 IU
HCPCS Level II code J2724 designates an intravenous administration of human protein C concentrate, measured per 10 IU. This biologic product has clinical relevance for patients with protein C deficiency or severe coagulopathy where replacement therapy is indicated. Nationally, accurate coding for high-cost biologics like protein C concentrate matters for clinical documentation, payer coverage determinations, and facility billing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of payer coverage patterns and common billing practices, plus clinical context about the therapy and typical sites of service. The publication outlines benchmarks for utilization reporting, documentation elements tied to administration setting, and how the code is used in facility and professional claims.
This summary provides a foundation for clinical administrators, coders, and billing teams to align documentation with the product description and anticipated service settings. Data not available in the input will be indicated where applicable in detailed sections.
Billing Code Overview
HCPCS Level II code J2724 represents an intravenous injection of human protein C concentrate, with the unit defined as 10 international units (IU). This code denotes the supplied biologic product administered via IV for patients requiring protein C replacement.
Service Type: Intravenous biologic infusion/injection
Typical Site of Service: Hospital inpatient or outpatient infusion center, emergency department, or other facility capable of IV biologic administration
Clinical & Coding Specifications
Clinical Context
A 28-year-old male with severe hemophilia A (congenital factor VIII deficiency) presents to an outpatient infusion center after sustaining a soft-tissue injury to the forearm. The patient requires replacement therapy with intravenous human protein C concentrate dosed in international units. The infusion is ordered as J2724 (Injection, protein c concentrate, intravenous, human, 10 IU) and administered by a registered nurse in an ambulatory infusion suite. Pre-infusion verification includes allergy check, weight-based dose calculation, venous access assessment, and documentation of baseline bleeding signs. The nurse performs medication reconciliation, prepares the product per manufacturer instructions, confirms informed consent, and administers the infusion via peripheral IV over the recommended infusion time while monitoring vital signs and for hypersensitivity. Post-infusion monitoring includes observation for infusion reactions, hemostatic response assessment, and documentation of lot number and expiration for traceability. If complications occur (infusion reaction or line complication), the treatment team documents event-specific interventions and may append appropriate modifiers for billing to reflect service circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances apply to the service. |