Summary & Overview
HCPCS Level II J7177: Human Fibrinogen Concentrate (Fibryga), Injection 1 mg
HCPCS Level II code J7177 represents an injectable dose of human fibrinogen concentrate (Fibryga), billed per 1 mg. This code captures administration of a plasma-derived coagulation factor used to treat congenital fibrinogen deficiency and other bleeding conditions that require fibrinogen replacement. Nationally, accurate coding for fibrinogen concentrate is important for correct clinical documentation, care continuity, and payment for high-cost biologic therapies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for fibrinogen concentrate, typical sites of service where J7177 is billed, and common billing modifiers used with injectable biologics. The publication outlines benchmark considerations for payer coverage and reimbursement practices, summarizes relevant policy updates influencing access to plasma-derived products, and highlights coding nuances that affect claims processing.
This summary serves clinicians, billing staff, and policy analysts seeking concise guidance on the code’s purpose, billing context, and where to look for payer-specific coverage details. Data not available in the input for specific payer rates, associated taxonomies, and ICD-10 pairings are noted where applicable.
Billing Code Overview
HCPCS Level II code J7177 describes an injection of human fibrinogen concentrate (Fibryga), 1 mg. This product is a plasma-derived fibrinogen replacement used to treat congenital fibrinogen deficiency and related bleeding disorders.
Service Type: Injection — hematologic/plasma-derived therapy
Typical Site of Service: Outpatient infusion clinic, hospital outpatient department, or specialty infusion center
Clinical & Coding Specifications
Clinical Context
A 34-year-old male with congenital afibrinogenemia presents to an outpatient hematology infusion center for scheduled replacement therapy with human fibrinogen concentrate (J7177). The patient has a history of spontaneous mucosal bleeding and required peri-procedural fibrinogen repletion prior to a dental extraction. The clinical workflow includes verification of diagnosis and recent fibrinogen level, review of prior infusion reactions, consent and allergy check, pharmacy preparation of weight-based dose using J7177 (1 mg units), administration via intravenous infusion by an infusion nurse under hematology supervision, vital sign monitoring during and for 30–60 minutes post-infusion, and documentation of lot number and amount administered. If used peri-operatively for bleeding control, coordination occurs with surgical or dental teams and anesthesiology. For emergent bleeding, the same product may be administered in the emergency department with hematology consultation and post-infusion monitoring for thrombosis and hypersensitivity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard claim | Use when no special circumstances apply to the infusion service. |
| 11 | Treatment management services | Use when the provider bills for ongoing management related to fibrinogen replacement.