Summary & Overview
HCPCS P9046: Infusion, Albumin (Human) 25%, 20 ml
HCPCS Level II code P9046 denotes a 20 ml vial of 25% human albumin used for infusion and related clinical supply purposes. Albumin products play a critical role in managing intravascular volume, hypoalbuminemia, and certain critical care indications; accurate coding ensures appropriate supply tracking and billing for high-concentration albumin. Nationally, proper use and coding of albumin affect hospital supply costs and reimbursement flows for infusion services.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for concentrated albumin, guidance on typical sites of service where P9046 is used, and what variables commonly influence coverage and billing for albumin infusions. The publication summarizes benchmarks and reimbursement considerations, highlights recent policy or coverage updates where available, and situates P9046 within the broader landscape of infusion and hospital supply codes.
This summary is intended for billing managers, revenue cycle professionals, and policy analysts seeking a concise reference on coding and payer context for concentrated albumin infusion supplies.
Billing Code Overview
HCPCS Level II code P9046 represents infusion of human albumin 25% in a 20 ml vial. The code describes the supply or administration unit for concentrated albumin solution used in volume expansion and other clinical indications where hyperoncotic albumin is required.
Service Type: Intravenous infusion / infusion supply
Typical Site of Service: Hospital inpatient, hospital outpatient, or infusion center
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Clinical & Coding Specifications
Clinical Context
A 68-year-old male with chronic liver disease and hypoalbuminemia presents to the outpatient infusion center for administration of human albumin 25%, 20 mL (P9046) to treat symptomatic low serum albumin and to support oncotic pressure during a paracentesis procedure. The clinical workflow begins with physician evaluation documenting the indication (for example, volume management for large-volume paracentesis or correction of severe hypoalbuminemia), informed consent, baseline vital signs and weight, verification of allergies, and review of recent laboratory values including serum albumin and coagulation profile. A registered nurse verifies the medication order in the electronic health record, prepares the 25% albumin in the supplied 20 mL vial, establishes peripheral IV access, and administers the product per facility protocol while monitoring for infusion reactions. Post-infusion monitoring includes vital signs, assessment for signs of fluid overload or allergic reaction, and documentation of lot number and expiration date for traceability. The typical site of service is an outpatient infusion center, ambulatory surgical center (if given during a procedure such as paracentesis), or hospital inpatient unit when administered as part of acute care management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |