Summary & Overview
HCPCS Level II J7511: Lymphocyte Immune Globulin, Rabbit, 25 mg
HCPCS Level II code J7511 denotes lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg — a parenteral immunosuppressive biologic used in clinical settings such as inpatient units and outpatient infusion centers. This code matters nationally because it represents a specialized therapy used in transplant medicine and other immune-mediated conditions where targeted lymphocyte depletion is required, with implications for hospital drug utilization, billing accuracy, and payer coverage policies.
Payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical role of the product, typical sites of service, and the billing context for J7511. The publication summarizes benchmarks and coverage considerations, highlights policy updates that affect billing and reimbursement for parenteral biologics, and provides clinical context relevant to utilization and coding accuracy. Data not available in the input for specific payers' coverage rules, pricing benchmarks, associated taxonomies, and ICD-10 mappings are noted where applicable.
Billing Code Overview
HCPCS Level II code J7511 describes lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg. This drug product is an immunosuppressive biologic preparation derived from rabbit antibodies targeting human T-lymphocytes and is typically administered by injection or infusion.
-
Service type: Parenteral biologic immunotherapy
-
Typical site of service: Inpatient hospital, outpatient infusion center, or other clinical settings equipped for parenteral administration
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old kidney transplant recipient who develops acute cellular rejection within weeks to months after transplant. The transplant nephrology team orders rabbit antithymocyte globulin (J7511) to induce lymphocyte depletion and reverse rejection. The patient presents to the hospital's infusion center or inpatient ward. Prior to administration, baseline vital signs, complete blood count, liver function tests, and renal function are reviewed. Pre-medication with acetaminophen, antihistamine, and corticosteroid is given per institutional protocol to reduce infusion reactions. The medication is reconstituted and administered intravenously by an oncology/transplant-trained nurse under physician or advanced practice clinician supervision. Vital signs and infusion tolerance are monitored frequently during and after the infusion. Documentation includes indication, dose in milligrams, lot number, administration route, start and stop times, any reactions, and applicable modifier(s) for billing. Typical sites of service are hospital inpatient wards, hospital outpatient infusion centers, and ambulatory transplant infusion clinics.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default or no modifier | Used when no other modifier applies to the service. |