Summary & Overview
HCPCS J7175: Injection, Human Factor X, 1 IU
HCPCS Level II code J7175 denotes injection of human factor X, measured per 1 international unit. This code captures administration of a biologic clotting factor used in replacement therapy for patients with factor X deficiency and related coagulation disorders. Nationally, accurate reporting of J7175 matters for clinical reimbursement, utilization tracking of high-cost biologics, and ensuring continuity of care for rare hematologic conditions.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role, typical sites of service, and the service type. The analysis provides benchmarks where available, describes common billing modifiers and coding context, and highlights policy and coverage considerations relevant to payers and provider billing workflows.
This publication supplies clinicians, billing professionals, and policy analysts with clear guidance on the code’s usage context, payer coverage landscape, and the operational implications of administering a billed unit-based coagulation factor. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J7175 represents an injection of human factor X, billed per 1 international unit (i.u.). The service is an injectable biologic replacement therapy intended to provide a specific coagulation factor.
Service Type: Therapeutic injection / biologic factor replacement
Typical Site of Service: Outpatient infusion clinic, 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 patient with a congenital or acquired deficiency of coagulation Factor X who requires replacement therapy for bleeding control or peri‑procedural prophylaxis. The patient presents to an outpatient infusion center, hospital inpatient ward, or ambulatory procedural unit. After hematology evaluation confirming factor X deficiency (congenital or acquired) or documented bleeding with low factor X activity, the clinician orders J7175 dosed in international units (I.U.) based on weight and desired target activity level.
The clinical workflow: the prescribing hematologist documents indication, target factor level, and dosing in the medical record; pharmacy verifies the order, performs product selection and compounding if needed; nursing obtains informed consent, verifies identity and allergy history, establishes IV access, and administers the injection/infusion per product instructions; post‑dose monitoring includes vital signs, infusion site checks, and assessment for hemostasis or adverse reactions. Documentation includes lot number, units administered, time, route, and site of service. The typical sites of service are outpatient infusion centers, hospital inpatient units, emergency departments for acute bleeding, and ambulatory surgical centers when used for procedural prophylaxis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used / default |