Summary & Overview
HCPCS Level II J3290: Tranexamic Acid Injection, 5 mg
HCPCS Level II code J3290 denotes the parenteral administration of tranexamic acid, 5 mg, a hemostatic agent used to reduce bleeding. Nationally, this code is relevant across acute and ambulatory care settings where tranexamic acid is administered for bleeding control or prophylaxis in clinical scenarios such as surgical bleeding, trauma, or certain hemorrhagic conditions. The code facilitates standardized billing and tracking of tranexamic acid injections and supports reimbursement and utilization monitoring for payers and providers.
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 tranexamic acid injections, expected sites of service, and typical service line classification. The publication also summarizes payer coverage considerations and benchmarks where available, highlights common modifier usage supplied in the input, and outlines gaps where input data are missing.
This brief equips health system financial and clinical leaders with the essential coding definition and practical context for HCPCS Level II code J3290, enabling consistent documentation and alignment with payer billing processes. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code J3290 represents an injection of tranexamic acid, 5 mg. This code describes the administration of a hemostatic agent used to reduce or prevent bleeding by promoting clot stability.
Service type: Injectable medication administration
Typical site of service: Outpatient clinic, hospital outpatient department, emergency department, or other ambulatory settings where parenteral medications are administered
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or hospital outpatient department with a clinical indication for systemic antifibrinolytic therapy, such as treatment or prevention of significant mucosal bleeding, heavy menstrual bleeding, perioperative hemorrhage prophylaxis in selected surgeries, or treatment of traumatic hemorrhage when tranexamic acid is indicated. The patient has an established diagnosis requiring intravenous tranexamic acid and a provider orders J3290 (injection, tranexamic acid, 5 mg). The clinical workflow includes verification of indication and allergies, informed consent, medication reconciliation, preparation of the intravenous dose by pharmacy or nursing per facility protocol, administration via IV push or infusion, monitoring for efficacy and adverse effects (e.g., thrombotic events, hypersensitivity), documentation of dose, route, site, lot number, and any concurrent medications. Billing staff attach the appropriate HCPCS code J3290, relevant service date, site of service (commonly outpatient infusion center, emergency department, ambulatory surgical center, or inpatient hospital), and applicable modifier(s) to reflect circumstances such as significant procedure alteration, discarded drug, or patient-related service variables.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) |