Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j7171-recombinant-adamts13-injection-10-iu
    Ask Trek AI about this page

    HCPCS Level II J7171: Injection, recombinant ADAMTS13, 10 IU

    HCPCS Level II code J7171 describes an injection of recombinant ADAMTS13 (adamts13, recombinant-krhn) dosed per 10 IU, used for replacement of the ADAMTS13 protease; the service is an injectable biologic therapy typically administered as an outpatient infusion or injection in an infusion center, hospital outpatient department, or specialty clinic for management of severe ADAMTS13 deficiency-related conditions.

    For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

    Customize your policy alerts

    Sign up for hcpcs J7171 policy alerts

    Get alerted when payer policies referencing J7171 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult admitted to an inpatient hematology or tertiary care medical center with acquired thrombotic thrombocytopenic purpura (aTTP) confirmed by severe ADAMTS13 deficiency and presence of ADAMTS13 autoantibodies. The patient presents with microangiopathic hemolytic anemia, thrombocytopenia, and organ ischemia (eg, neurologic symptoms, renal dysfunction). Initial management includes plasma exchange and immunosuppression (corticosteroids, rituximab). Recombinant ADAMTS13 (J7171) is administered as an intravenous injection in measured international units to restore ADAMTS13 activity when available under approved indications or investigational protocols.

    Care pathway and workflow:

    • Admission to inpatient unit or specialty infusion center for acute aTTP or for scheduled replacement/maintenance dosing.

    • Baseline documentation: diagnosis codes, baseline labs (CBC, LDH, creatinine, haptoglobin), ADAMTS13 activity and inhibitor testing, consent for therapy if required.

    • Pharmacy preparation and verification of J7171 dose (10 IU vials or multiples) and shelf‑handling per manufacturer guidance.

    • Administration by trained infusion nurse under hematology oversight. Typical site of service is inpatient hospital, observation unit, or hospital-based infusion center. Dosing frequency and duration are determined by treating hematologist and protocol.

    • Monitoring during and after injection for infusion reactions, hemolysis parameters, platelet recovery, and organ function. Documentation includes lot number, units administered, route (intravenous), and any applicable modifier (eg, wasted product reported with JW).

    • Subsequent billing: report J7171 with appropriate modifier(s) to indicate single/multiple vials, product wastage, services related to inpatient status, or circumstances such as reduced services or discontinued administration.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipunctureUsed for baseline and monitoring labs (CBC, hemolysis markers, ADAMTS13 testing) before or after J7171 administration.

    36561 | Insertion of non-tunneled centrally inserted central venous catheter (eg, for plasmapheresis) | Performed when central access is required for concurrent plasma exchange or frequent infusions in severe aTTP patients.

    36514 | Collection of blood from catheter, percutaneous, initial tubing change | Used when drawing labs through central venous access associated with inpatient infusion therapy.

    36215 | Selective catheter placement, arterial, for diagnostic angiography | Used only if diagnostic angiography is needed for organ ischemia evaluation related to thrombotic events; included as an adjunct procedure in complex cases.

    96413 | Chemotherapy administration, intravenous infusion technique, up to 1 hour | Used when payer requires reporting an infusion/IV drug administration code for biologics given by infusion and time-based reporting is appropriate.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    92Modifier 92 (Alternative Laboratory Platform Testing) is used when laboratory tests are performed with single‑use, disposable, portable kits or transportable instruments. The AMA defines it for tests…- Use modifier 92 when a laboratory test is performed using a single‑use, disposable analytical device or kit (an alternative laboratory platform) that is portable and may be taken to or near the…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    2080P0207X
    163W00000X
    363L00000X
    163WP0808X
    170100000X
    261QR0404X
    2080P0202X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    D59.9Acquired hemolytic anemia, unspecified
    D62Acute posthemorrhagic anemia
    D68.1Hereditary factor XI deficiency
    D68.4Acquired coagulation factor deficiency
    D68.52Prothrombin gene mutation
    D68.9Coagulation defect, unspecified
    D69.0Allergic purpura
    D69.2Other nonthrombocytopenic purpura
    D69.3Immune thrombocytopenic purpura
    D69.49Other primary thrombocytopenia

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    Electric Tumor Treatment Field Therapy (for Tennessee Only)Colorado Rocky Mountain Health Plans2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    OmisirgeCigna2026-11-01
    Hematology - AdzynmaCigna2026-10-15
    Transcatheter Arterial Chemoembolization for Liver Tumorspremerabluecrossofwashington2026-10-01
    Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bonepremerabluecrossofwashington2026-10-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

    • More pages

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.