Summary & Overview
HCPCS Level II J3291: Tranexamic Acid Injection, 5 mg
HCPCS Level II code J3291 denotes an injection of tranexamic acid in sodium chloride, 5 mg. Tranexamic acid is an antifibrinolytic agent used to reduce or prevent bleeding in various clinical settings. Nationally, accurate coding for parenteral tranexamic acid is important for care coordination, inventory management, and consistent claims adjudication across payers.
Key payers covered 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, typical sites of service where this parenteral medication is administered, and the billing context associated with HCPCS Level II code J3291.
This publication provides national benchmarks and policy-relevant notes where available, clarifies common billing practices for injectable tranexamic acid, and highlights areas where payers and providers frequently align or differ in coverage and billing workflows. Data on modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service-line details are noted as available elsewhere in the broader publication. Data not available in the input.
Billing Code Overview
HCPCS Level II code J3291 represents an injection of tranexamic acid in sodium chloride, 5 mg. This code describes a parenteral formulation of tranexamic acid administered in a measured 5 mg unit dose.
Service type: Injection / Parenteral Medication
Typical site of service: Outpatient clinic, hospital outpatient department, ambulatory surgical center, or other settings where parenteral medications are administered.
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Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient presenting to an ambulatory infusion center, emergency department, or operating room for administration of intravenous tranexamic acid to reduce or prevent bleeding. Indications include active mucosal bleeding (for example epistaxis uncontrolled by local measures), acute traumatic hemorrhage, perioperative prophylaxis to reduce surgical bleeding, or heavy menstrual bleeding refractory to first-line outpatient therapy. A common workflow: the clinician evaluates the patient and documents indication and consent; pharmacy prepares J3291 (tranexamic acid in sodium chloride, 5 mg) as an IV push or infusion per protocol; nursing verifies patient identity, IV access, and allergies; the medication is administered with vital sign monitoring and documentation of dose, route, and lot number; response and any adverse events are recorded; billing uses HCPCS J3291 with applicable service and place-of-service codes for infusion center, emergency department, or inpatient/OR settings as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
GT | Via interactive audio and video telecommunications | Use when the service includes telehealth interactive supervision of administration (rare for IV meds). |
| Significant, separately identifiable evaluation and management service by the same physician on the same day | Use when an E/M visit is performed on the same day as medication administration and is distinct from the infusion event.