Summary & Overview
HCPCS J7180: Injection, Factor XIII (Antihemophilic Factor, Human), 1 i.u.
HCPCS Level II code J7180 represents an injectable human antihemophilic factor for factor XIII, billed per international unit. This code captures administration and supply of a specialized coagulation factor used in patients with congenital or acquired factor XIII deficiency, a clinically significant bleeding disorder requiring replacement therapy. Nationally, accurate coding of clotting factor products affects access, utilization tracking, and reimbursement for high-cost biologic therapies.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of clinical context for factor XIII replacement, the common sites where the service is delivered (outpatient infusion centers, hospital outpatient departments, and physician offices), and the implications for billing workflows.
The publication summarizes benchmarks and policy-relevant points readers should expect: billing and coding clarity for per-unit factor products, payer coverage patterns and authorization considerations, and documentation elements that align clinical indication with the coded unit of therapy. Data not provided in the input are noted where applicable. The focus is national policy and operational context rather than state-level rules or treatment recommendations.
Billing Code Overview
HCPCS Level II code J7180 describes an injection of factor XIII (antihemophilic factor, human) measured per 1 international unit (i.u.). The service type is injectable clotting factor therapy, used for replacement or augmentation of factor XIII in patients with deficiency or bleeding disorders. The typical site of service is an outpatient infusion clinic, hospital outpatient department, or physician office where parenteral biologic therapies are administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric individual with severe congenital Factor XIII deficiency or an acquired deficiency presenting with bleeding, poor wound healing, or prophylactic needs prior to surgery or childbirth. The patient is evaluated in a hematology clinic or hospital setting by a hematologist. Indications for administration of J7180 (Factor XIII, human, measured per international unit) include documented low factor XIII activity on laboratory testing, history of spontaneous bleeding (including intracranial hemorrhage or delayed wound bleeding), or planned invasive procedures where replacement is required for hemostatic support. The clinical workflow includes confirmation of indication and baseline coagulation studies, calculation of dosing based on body weight and target activity, verification of product availability and lot information, informed consent and allergy review, IV access placement, administration of the reconstituted product under standard infusion protocols, and post‑infusion monitoring for allergic reaction, infusion site complications, and clinical hemostasis. Documentation includes dose in international units, lot number, route, site, time, and any immediate adverse events. Supply management and billing use J7180 billed per international unit with appropriate modifiers as needed for payer reporting and reimbursement.
Coding Specifications
| Modifier | Description | When to Use |
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