Summary & Overview
HCPCS J7519: Injection, mycophenolate mofetil, 10 mg
HCPCS Level II code J7519 denotes a 10 mg injection of mycophenolate mofetil, an immunosuppressive medication used in transplant medicine and certain autoimmune conditions. As a drug-specific HCPCS Level II code, J7519 is used on outpatient and professional service claims to identify administered units of the injectable formulation. Accurate use of this code matters nationally for drug utilization tracking, billing accuracy, and payer adjudication given the high clinical and cost implications of immunosuppressive therapy.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clear outline of what the code represents, the typical clinical settings where the injectable is administered, and which payers are included in comparative coverage considerations. The publication provides benchmarks for coding and billing practices, notes common billing modifiers used in associated service lines, and summarizes the clinical context for mycophenolate mofetil injections without offering clinical recommendations. Where specific data elements are not provided in the source, the report indicates that information is not available in the input.
Billing Code Overview
HCPCS Level II code J7519 represents an injection of mycophenolate mofetil, 10 mg. This code covers the drug formulation and describes a parenteral administration of mycophenolate mofetil in a single 10 mg unit.
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Service type: Medication administration (injectable immunosuppressant)
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Typical site of service: Infusion center, outpatient clinic, hospital outpatient department, or other settings where injectable medications are administered
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Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with a history of severe autoimmune disease (e.g., refractory lupus nephritis or severe systemic vasculitis) presents to an outpatient infusion center for medication administration. The treating specialist — commonly a rheumatologist, nephrologist, or transplant specialist — orders parenteral mycophenolate mofetil when oral administration is not feasible (for example, due to gastrointestinal intolerance, temporary nil per os status, or during hospitalized initiation). The clinical workflow includes pre-infusion nursing assessment (vitals, weight, allergy check), verification of the provider order and medication dose, preparation of J7519 (mycophenolate mofetil, 10 mg per unit) by pharmacy under sterile conditions, administration via intravenous infusion or IV push per institutional protocol, monitoring for infusion reactions, and documentation of lot number and amount administered. Billing captures the HCPCS Level II code J7519 for the quantity administered, and applicable modifiers are appended to reflect specific circumstances such as partial administration, patient status, or medication waste. Typical sites of service are outpatient infusion centers, hospital outpatient departments, and inpatient hospital settings when IV administration is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |