Summary & Overview
HCPCS J3364: Urokinase Injection, 5,000 IU Vial
HCPCS Level II code J3364 denotes an injection of urokinase supplied as a 5,000 IU vial, a pharmacologic thrombolytic used to dissolve blood clots in acute clinical care. Nationally, accurate coding for thrombolytic agents matters for clinical documentation, reimbursement consistency across payers, and alignment with facility pharmacy billing practices. This code is relevant in settings that provide acute clot management, including hospital inpatient and outpatient departments, emergency departments, and procedural suites.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding context, common billing modifiers, and the typical service lines and sites where J3364 is used. The publication highlights benchmarking considerations for unit reporting, common billing scenarios, and policy-relevant issues that affect coverage and claims processing for injectable thrombolytics.
This summary equips billing managers, clinical coders, and policy analysts with the essential clinical and administrative context for J3364, including what to expect in payer interactions and which operational areas (pharmacy-dispensed injections in acute care settings) most commonly generate this code. Data not available in the input will be identified in respective sections of the full publication.
Billing Code Overview
HCPCS Level II code J3364 describes an injection of urokinase, supplied as a 5,000 IU vial. This code represents a pharmacologic thrombolytic agent administered for clot dissolution in clinical settings where urokinase is indicated.
Service type: Therapeutic injection (thrombolytic agent)
Typical site of service: Hospital inpatient or outpatient setting, emergency department, or procedure suite
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult hospitalized with an acute thrombotic occlusion of a central venous catheter or an intravascular thrombus requiring pharmacologic thrombolysis. A common scenario is a patient in the intensive care unit or inpatient ward with a tunneled dialysis catheter that has become occluded and will not aspirate; the vascular access team evaluates and administers intraluminal thrombolytic therapy. After reviewing contraindications (recent major surgery, active bleeding, uncontrolled hypertension), a clinician draws up J3364 (urokinase, 5000 IU vial) and instills the appropriate dose into the catheter lumen or delivers it via a catheter-directed infusion for catheter clearance or localized thrombolysis. Nursing documents the dose, route, site, time, and patient response; monitoring for bleeding complications and vital signs occurs for several hours after administration. If catheter patency is restored, the device is flushed and use resumed; if not, further interventions such as mechanical declotting or catheter replacement are considered by the care team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when a partial dose of urokinase is administered or procedure is partially reduced in scope. |