Summary & Overview
HCPCS J3247: Secukinumab Injection, Intravenous, 1 mg
HCPCS Level II code J3247 denotes the intravenous injection of secukinumab, billed per 1 mg unit. As an HCPCS Level II injectable drug code, J3247 is used in facility and outpatient infusion settings to document dosing and support payment for the biologic agent. Nationally, drug administration codes such as J3247 are important for tracking utilization of high-cost biologics and ensuring proper billing of unit-based drug supplies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how this code is used in claims, payer coverage considerations, unit-based billing implications, and typical sites of service where intravenous secukinumab is administered. The publication also outlines relevant benchmarks and policy considerations affecting injectable biologics billing, clinical context for IV administration, and common modifiers and billing practices (where available). Data not available in the input is noted where applicable.
This summary provides clinicians, billing professionals, and policy analysts a concise reference on HCPCS Level II code J3247, its clinical use for IV secukinumab administration, and the payer landscape affecting reimbursement and utilization tracking.
Billing Code Overview
HCPCS Level II code J3247 describes an intravenous injection of secukinumab, billed per 1 mg unit. This code represents administration of the biologic agent secukinumab via intravenous (IV) route, typically performed when IV delivery is clinically indicated.
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Service type: Intravenous medication administration
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Typical site of service: Hospital outpatient infusion center or other facility-based infusion setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45–65-year-old adult with moderate-to-severe plaque psoriasis or ankylosing spondylitis who requires parenteral biologic therapy. The patient presents to an infusion center or hospital outpatient department for administration of intravenous secukinumab when intravenous formulation is used for induction or when a patient cannot receive subcutaneous injections. The workflow includes verification of the order, allergy and medication reconciliation, baseline vital signs and consent, preparation of the medication by pharmacy under sterile technique, IV access placement, administration of the intravenous infusion of J3247 (secukinumab, IV, per mg) with monitoring for infusion reactions, documentation of dose and lot numbers, and post-infusion observation prior to discharge. Typical sites of service are outpatient infusion centers, hospital outpatient departments, and ambulatory surgical centers when clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier required by payer | Use when no special circumstances apply and the service is billed normally |
22 |