Summary & Overview
HCPCS J3240: Thyrotropin Alpha Injection, 0.9 mg (1.1 mg vial)
HCPCS Level II code J3240 covers injection of thyrotropin alpha, 0.9 mg supplied in a 1.1 mg vial, used primarily as a diagnostic injectable in endocrine testing. Nationally, this code matters because it identifies use of a specialized biologic agent for thyroid-related diagnostic protocols and drives billing, coverage determinations, and site-of-service reporting for outpatient diagnostic procedures. Payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides readers with a concise overview of clinical use, payer coverage landscape, and the billing context for J3240. Readers will find benchmark information where available, explanations of where the service is typically provided, and summaries of common billing considerations tied to HCPCS Level II reporting. It also highlights policy-relevant elements that affect utilization and coding, such as the product-specific unit definition and the outpatient administration setting. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J3240 represents an injection of thyrotropin alpha, with a dosage unit of 0.9 mg provided in a 1.1 mg vial. This product is used as a diagnostic agent in certain endocrine evaluations that require recombinant human thyrotropin.
Service type: Therapeutic/diagnostic injection
Typical site of service: Outpatient clinic or hospital outpatient department, including specialty endocrinology clinics and diagnostic imaging centers where injectable diagnostic agents are administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a history of differentiated thyroid carcinoma who requires serum thyroglobulin stimulation or confirmation of thyroid remnant ablation prior to diagnostic radioactive iodine scanning. The patient presents to an outpatient nuclear medicine or endocrinology clinic after thyroidectomy and prior radioiodine therapy. The clinical workflow includes: pre-visit consent and allergy check; review of recent thyroid hormone therapy (levothyroxine) and decision to use recombinant human thyrotropin (rhTSH) rather than thyroid hormone withdrawal; administration of J3240 (thyrotropin alpha, 0.9 mg vial) via intramuscular injection on two consecutive days per standard protocol; monitoring for immediate adverse reactions for 30–60 minutes post-injection in the clinic; scheduling of diagnostic whole-body radioiodine scan or serum thyroglobulin measurement 24 hours after the second injection; documentation of lot number, vial amount, route (intramuscular), date/time of each injection, and patient tolerance. Typical sites of service are outpatient hospital-based nuclear medicine departments, ambulatory surgical centers with nuclear medicine capability, or endocrinology outpatient clinics equipped for parenteral administration and short-term monitoring. Typical patient scenario: a 52-year-old female post-total thyroidectomy for papillary thyroid carcinoma, on levothyroxine, who requires stimulated thyroglobulin testing and diagnostic I-123 scan; the care team elects rhTSH as the stimulation method and bills J3240 for each 0.9 mg vial supplied and administered.
Coding Specifications
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