Summary & Overview
HCPCS J3402: Injection of Remestemcel-l-rknd, Therapeutic Dose
HCPCS Level II code J3402 denotes an injection of remestemcel-l-rknd billed per therapeutic dose, an injectable biologic therapy used in specialized clinical settings. This code matters nationally as it captures utilization and reimbursement for a high-cost, specialty biologic product administered by clinicians in outpatient infusion centers, hospital outpatient departments, or physician offices. Accurate coding supports claims processing, coverage determinations, and tracking of specialty therapeutic use.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of what the code represents, typical sites of service, common modifiers when they are documented elsewhere, and where to look for policy and coverage guidance. The publication also outlines expected benchmarks for utilization and reimbursement context, summarizes relevant policy updates affecting specialty biologics billing, and provides clinical context for the injection's administration and billing implications.
This summary is written for a national audience and aims to help billing managers, revenue cycle professionals, and policy analysts quickly understand the significance of HCPCS Level II code J3402, what to expect in payer interactions, and which topics to consult for more detailed coding and coverage considerations.
Billing Code Overview
HCPCS Level II code J3402 represents an injection of remestemcel-l-rknd, billed per therapeutic dose. The service is an injectable biologic therapy administered as a therapeutic dose intended for clinical use.
Service Type: Injectable biologic therapy
Typical Site of Service: Outpatient infusion or injection suite, hospital outpatient department, or physician office
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric recipient with severe, treatment-refractory inflammatory or immune-mediated complications (for example, steroid-refractory acute graft-versus-host disease) for whom remestemcel-l-rknd is being administered as a cell-based therapeutic. The clinical workflow begins with specialty hematology/oncology or transplant clinic evaluation documenting failure of standard therapies. Inpatient or outpatient infusion center scheduling follows multidisciplinary review; informed consent and eligibility verification are completed. On the day of service, the product is thawed and prepared by an authorized pharmacy or cell-therapy laboratory, bedside or infusion nursing performs intravenous administration of the therapeutic dose, and monitoring for infusion reactions and vital signs occurs for the recommended observation period. Post-infusion documentation includes dose administered, lot and product identifiers, any immediate adverse events, and instructions for follow-up. Billing uses HCPCS Level II code J3402 to report each therapeutic dose administered; appropriate modifiers are appended when applicable to indicate unusual services, bilateral/multiple procedures, or payer-specific circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default / No modifier | Use when no special modifier applies to the claim. |