Summary & Overview
HCPCS Level II J7178: Injection, Human Fibrinogen Concentrate, 1 mg
HCPCS Level II code J7178 identifies a 1 mg unit of human fibrinogen concentrate supplied for injection. As a specialized biologic hemostatic therapy, this code captures administration of fibrinogen replacement used in bleeding disorders and perioperative coagulopathy. Nationally, accurate coding of fibrinogen concentrates supports claims processing, utilization tracking, and appropriate benefit design for high-cost, clinically critical blood products.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the product, typical sites of service where it is administered, and the payer landscape addressed in the full publication. The report outlines benchmarks and coverage considerations relevant to hospital outpatient departments, infusion centers, and physician offices. It also highlights coding nuances tied to HCPCS Level II reporting for single-unit billing and the implications for utilization monitoring and prior authorization workflows.
This summary is intended for coding managers, revenue cycle leaders, pharmacy and therapeutics committees, and clinicians involved in managing hemostatic therapies nationally. Data not provided in the input—such as specific payer policies, reimbursement rates, ICD-10 pairings, and associated taxonomies—are noted as unavailable and are addressed where applicable in the full publication.
Billing Code Overview
HCPCS Level II code J7178 describes an injection of human fibrinogen concentrate, not otherwise specified, 1 mg. This entry represents a biologic hemostatic agent supplied for intravenous administration to replace or augment fibrinogen in patients with congenital or acquired fibrinogen deficiency.
Service type: Therapeutic infusion/injection of clotting factor concentrate
Typical site of service: Hospital outpatient department, infusion center, or physician office
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with congenital afibrinogenemia, acquired hypofibrinogenemia from disseminated intravascular coagulation, or perioperative fibrinogen deficiency following major hemorrhage who requires fibrinogen replacement. The patient presents to the hospital or an outpatient infusion center with active bleeding, perioperative planned replacement before high‑risk surgery, or laboratory-confirmed low fibrinogen (e.g., Clauss fibrinogen <1.0 g/L) with clinical bleeding risk. The clinical workflow includes: initial coagulation assessment (PT/INR, aPTT, fibrinogen level), hematology consult when indicated, ordering J7178 dosed in mg according to body weight and target fibrinogen level, product preparation by pharmacy or blood bank, administration via IV infusion by trained nursing staff, monitoring for infusion reactions and thrombotic events, post‑infusion fibrinogen level check, and documentation of indication, lot number, and amount administered. Typical sites of service are inpatient hospital (including perioperative and ICU settings), outpatient hospital infusion center, and ambulatory surgical centers when used perioperatively.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no other modifier applies |