Summary & Overview
HCPCS J2802: Injection, romiplostim, 1 microgram
HCPCS Level II code J2802 identifies a 1 microgram unit of romiplostim, an injectable medication used to stimulate platelet production. Nationally, accurate coding for romiplostim matters for clinical management of thrombocytopenia and for consistent drug billing across outpatient infusion centers and physician offices. This code underpins unit-based billing for dose calculations and inventory control and is critical for payer reimbursement processes.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how J2802 is used in practice, typical sites of service, and common billing considerations. The publication provides benchmarks where available, summarizes relevant policy updates that affect coverage and payment, and outlines clinical context relevant to dosing and administration of romiplostim. For items not provided in the source input, such as detailed payer-specific rates, taxonomies, and diagnosis linkages, the report notes that data is not available in the input. This summary serves as a national-level reference for payers, billing staff, and clinical managers handling injectable romiplostim services.
Billing Code Overview
HCPCS Level II code J2802 represents an injection of romiplostim, dosed as 1 microgram per unit. This code is used to report administration of the romiplostim product in a parenteral form.
Service type: Injectable medication administration
Typical site of service: Outpatient infusion/ambulatory clinic or physician office
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic immune thrombocytopenia (ITP) presents for outpatient administration of romiplostim. The patient has persistent thrombocytopenia refractory to corticosteroids and requires weekly subcutaneous dosing titrated by platelet response. Prior to arrival, nursing verifies the latest platelet count, medication dose in micrograms (mcg) based on weight, and consent for biologic therapy. The medication J2802 (romiplostim, 1 microgram) is drawn from vials and compounded into syringes by trained pharmacy or clinic staff. A licensed nurse or pharmacist administers the subcutaneous injection in an infusion or procedure room within an outpatient infusion clinic, hematology clinic, or ambulatory surgical center, documenting lot numbers, dose in mcg, site of injection, and patient response. Follow-up includes monitoring platelet counts 1–2 times weekly during dose adjustments and reporting any adverse events such as thromboembolic events or significant changes in platelet count. Billing captures the drug unit as J2802 multiplied by the total micrograms administered, with applicable modifiers appended when relevant to the encounter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard claim submission | Use when no special circumstances apply to the service. |