Summary & Overview
HCPCS J7504: Lymphocyte Immune Globulin (Antithymocyte), Equine, 250 mg
HCPCS Level II code J7504 identifies lymphocyte immune globulin (antithymocyte globulin), equine, 250 mg, delivered parenterally. This immunosuppressive biologic is used in clinical contexts such as prevention or treatment of acute cellular rejection in organ transplantation and other conditions requiring T-lymphocyte suppression. Nationally, accurate coding of high-cost biologics like J7504 matters for payment integrity, utilization tracking, and ensuring appropriate site-of-service documentation for infusion therapies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context, typical settings of administration, and the operational elements relevant to billing such a parenteral biologic. Readers will find benchmarks and policy-focused content where available, including reimbursement and coverage themes, common payer considerations, and coding practice implications. If specific payer policies or rate tables are absent, those data points are noted as not available in the input.
This summary is intended for clinicians, billing professionals, and policy analysts seeking a national-level briefing on HCPCS Level II code J7504, its clinical role, and the payer landscape affecting parenteral biologic therapy billing and coverage.
Billing Code Overview
HCPCS Level II code J7504 describes lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg. This product is an immunosuppressive biologic preparation derived from equine sources and formulated for parenteral administration.
Service type: Parenteral biologic therapy
Typical site of service: Hospital inpatient or outpatient infusion settings, including transplant centers and specialty infusion clinics
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with severe acute cellular rejection after a renal transplant presents to the hospital for immunosuppressive therapy. The transplant nephrology team orders equine antithymocyte globulin for T‑cell depletion following biopsy-proven rejection unresponsive to corticosteroid pulse therapy. The patient is admitted to an inpatient unit or treated in an infusion center with capabilities for close monitoring. Premedication with acetaminophen and diphenhydramine is administered, intravenous access is established, and baseline vital signs and laboratory studies (CBC, CMP) are obtained. The pharmacy verifies dosing for J7504 (lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg) and prepares the product under sterile conditions. Nursing administers the medication intravenously per protocol with continuous monitoring for infusion reactions, anaphylaxis, serum sickness, and cytopenias. Post-infusion monitoring includes serial vital signs, laboratory monitoring of blood counts and renal function, and documentation of administered dose, lot number, and any adverse events in the medical record. The clinical workflow involves coordination among transplant surgery/nephrology, pharmacy, nursing, and billing to ensure correct coding, documentation of indication, route, dose, and any modifier-relevant circumstances (e.g., emergency administration, discontinued infusion, or significant procedural complexity).
Coding Specifications
| Modifier | Description | When to Use |
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