Summary & Overview
HCPCS J2995: Injection, Streptokinase, per 250,000 IU
HCPCS Level II code J2995 identifies an injectable dose of streptokinase, specified per 250,000 international units. Streptokinase is a systemic thrombolytic agent used in acute thrombotic conditions; accurate coding affects medication billing, hospital pharmacy charges, and overall claims processing. Nationally, precise use of this HCPCS code supports consistent capture of drug utilization and payment for parenteral thrombolytic therapy.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for J2995, common settings where streptokinase is administered, and the types of benchmarks and coverage considerations typically examined by payers. The publication outlines payer coverage patterns, billing benchmarks, and coding considerations relevant to pharmacy and acute care service lines.
This summary provides clinicians, coding professionals, and revenue cycle staff with context on how J2995 is used in practice, what to expect from major payers, and where coverage or coding clarifications are commonly needed. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J2995 represents an injection of streptokinase, billed per 250,000 IU. This code denotes a thrombolytic medication administered parenterally for lysis of thrombi in relevant clinical scenarios.
Service Type: Medication administration / injectable thrombolytic therapy
Typical Site of Service: Hospital inpatient or emergency department, and other acute care settings where intravenous thrombolytic therapy is provided.
Clinical & Coding Specifications
Clinical Context
A 56-year-old male presents to the emergency department with acute chest pain and electrocardiographic evidence of an ST-elevation myocardial infarction (STEMI) within a community hospital without immediate percutaneous coronary intervention capability. After rapid assessment by the emergency medicine and cardiology teams, the patient is determined to be an appropriate candidate for fibrinolytic therapy. Streptokinase is ordered and prepared for intravenous infusion; dosing is calculated in units and billed per 250,000 IU increment using J2995. The clinical workflow includes informed consent, baseline coagulation studies, administration of pre‑treatment medications (e.g., aspirin, heparin if indicated), IV infusion of streptokinase in the ED or critical care area, continuous cardiac monitoring, and serial assessment for reperfusion and bleeding. Post‑administration care includes transfer to a monitored bed, repeat ECGs, monitoring for hemorrhagic complications, and coordination with interventional cardiology for possible transfer for rescue PCI if indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when streptokinase administration requires substantially greater resource use due to complexity (documented justification). |