HCPCS J3365: Urokinase Injection, 250,000 i.u. Vial - OpenPayer

Summary & Overview

HCPCS J3365: Urokinase Injection, 250,000 i.u. Vial

HCPCS Level II code J3365 denotes an intravenous vial of urokinase, 250,000 international units, used for pharmacologic thrombolysis. As a specified drug code in the HCPCS Level II system, J3365 is relevant to hospitals and acute care providers that administer thrombolytic therapy for conditions requiring clot dissolution. Nationally, accurate coding of thrombolytic agents affects clinical documentation, billing across payers, and drug utilization monitoring.

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 urokinase use, common sites of service where billing occurs, and which payers are commonly engaged in reimbursement and coverage decisions. The publication also outlines benchmarking elements and policy considerations relevant to billing practice and claims adjudication for J3365.

This summary provides a practical reference for revenue cycle, coding professionals, and clinical administrators seeking clarity on the code’s purpose, typical use settings, and payer landscape. Data not available in the input for specific ICD-10 pairings, modifier utilization patterns by payer, and related HCPCS codes are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareJ3365HCPCS Level IIurokinasethrombolytic therapyintravenous injectionhospital billingdrug administrationmedical coding

Billing Code Overview

HCPCS Level II code J3365 represents an intravenous injection of urokinase, supplied as a 250,000 international unit (i.u.) vial. This code describes the drug product and presentation used for thrombolytic therapy involving urokinase.

Service Type: Intravenous thrombolytic medication administration

Typical Site of Service: Hospital inpatient or outpatient settings, including emergency departments and interventional suites where intravenous thrombolytic therapy is administered

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 68-year-old hospitalized patient with an acute occlusive deep venous thrombosis (DVT) of the lower extremity presents with severe limb swelling, pain, and threatened tissue perfusion despite systemic anticoagulation. Interventional radiology is consulted for catheter-directed thrombolysis. The planned procedure includes ultrasound-guided venous access, placement of a multi-sidehole infusion catheter across the thrombus, and continuous infusion of urokinase supplied as J3365 (Injection, iv, urokinase, 250,000 i.u. vial). The clinical workflow includes pre-procedure consent, baseline labs (coagulation panel, CBC), vascular imaging (venogram or duplex ultrasound), catheter placement under fluoroscopic guidance, initiation and monitoring of urokinase infusion in the interventional radiology suite or vascular lab, serial neurovascular checks and hematologic monitoring during infusion, and post-procedure venographic assessment with possible adjunctive mechanical thrombectomy or angioplasty.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity of thrombolytic administration is substantially greater than typical (extensive additional time for complex catheter placement).

Related Codes

HCPCS-J1265-DOPAMINE-40MG-INJECTION

HCPCS J1265: Injection, Dopamine HCl 40 mg

HCPCS-J2460-OXYTETRACYCLINE-INJECTION-UP-TO-50-MG

HCPCS J2460: Injection, Oxytetracycline HCl, Up to 50 mg

HCPCS-J0162-EPINEPHRINE-FRESENIUS-0-1-MG-INJECTION

HCPCS Level II J0162: Epinephrine (Fresenius) Injection, 0.1 mg

HCPCS-J1931-LARONIDASE-INJECTION-0-1-MG

HCPCS Level II J1931: Injection, laronidase, 0.1 mg

HCPCS-J1456-FOSAPREPITANT-TEVA-INJECTION-1MG

HCPCS J1456: Fosaprepitant (Teva) Injection, 1 mg

HCPCS-J1812-INSULIN-FIASP-PER-5-UNITS

HCPCS J1812: Insulin (Fiasp), per 5 units

HCPCS-J0588-INCOBOTULINUMTOXIN-A-INJECTION-1-UNIT

HCPCS Level II J0588: Injection, incobotulinumtoxin A, 1 unit

HCPCS-J1811-INSULIN-FIASP-FOR-INSULIN-PUMP

HCPCS J1811: Insulin (Fiasp) for Insulin Pump, per 50 Units

HCPCS-J1940-FUROSEMIDE-INJECTION-UP-TO-20-MG

HCPCS J1940: Injection, Furosemide up to 20 mg

HCPCS-J1240-DIMENHYDRINATE-INJECTION-UP-TO-50-MG

HCPCS J1240: Injection, dimenhydrinate, up to 50 mg

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Taxonomy Code	Specialty	Notes
2086S0002X	Interventional Radiology	Primary specialists performing catheter-directed thrombolysis and infusion of urokinase.
208D00000X	Vascular Surgery	Vascular surgeons who perform endovascular thrombolysis and adjunctive procedures.
363L00000X	Hematology	Hematologists involved in anticoagulation and thrombolytic therapy management.
207RC0000X	Emergency Medicine	Emergency physicians who may initiate thrombolytic therapy and coordinate transfer for intervention.
367H00000X	Critical Care Medicine	Intensivists overseeing critically ill patients receiving continuous thrombolytic infusions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.401`	Acute embolism and thrombosis of unspecified deep veins of right lower extremity	Typical indication for catheter-directed thrombolysis with urokinase to rapidly lyse occlusive thrombus and restore venous flow.
`I82.402`	Acute embolism and thrombosis of unspecified deep veins of left lower extremity	As above, indicating left-sided acute DVT potentially requiring thrombolytic infusion.
`I82.403`	Acute embolism and thrombosis of unspecified deep veins of bilateral lower extremities	Bilateral DVTs that may require bilateral catheter-directed thrombolysis and higher monitoring intensity.
`I82.501`	Chronic embolism and thrombosis of unspecified deep veins of lower extremity	Chronic or subacute thrombus where adjunctive thrombolysis may be considered in select cases to alleviate post-thrombotic symptoms.
`I26.99`	Other pulmonary embolism without acute cor pulmonale	Pulmonary embolism patients with residual large proximal DVT may receive catheter-directed thrombolysis in specialized settings.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36011`	Introduction of needle or intracatheter, intravenous, for diagnostic or therapeutic injection, not for infusion	Used for initial venous access when separate percutaneous catheter introduction is reported prior to placing infusion catheter for urokinase.
`36245`	Selective catheter placement, venous, including radiological supervision and interpretation	Used to document selective venous catheter placement and venography performed before and after urokinase infusion.
`37211`	Revascularization, endovascular, open or percutaneous, venous, with thrombolysis (includes infusion), initial vessel	Used when catheter-directed thrombolysis procedures are reported as the principal endovascular revascularization service including infusion of urokinase.
`37212`	Revascularization, endovascular, venous, subsequent vessel(s)	Used for additional venous segments treated with thrombolysis or adjunctive therapy during the same session.
`36556`	Insertion of non-tunneled centrally inserted central venous catheter (e.g., for prolonged infusion)	Used when a central venous catheter is placed for prolonged urokinase infusion or monitoring.