Summary & Overview
HCPCS P9047: Infusion of Human Albumin 25%, 50 ml
HCPCS Level II code P9047 represents the intravenous infusion of human albumin, 25% concentration in a 50 ml vial. Albumin infusions are used nationally for volume expansion, management of hypoalbuminemia, and select critical care and surgical indications, making this code relevant across hospitals, infusion centers, and emergency departments. Payment and coverage for albumin products can affect acute care costs, blood-product utilization, and hospital pharmacy management.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coverage patterns, coding considerations, and clinical context for use of concentrated albumin. The publication summarizes benchmark rates and utilization trends where available, highlights policy updates that influence coverage of albumin products, and outlines clinical scenarios driving use of P9047.
This analysis provides operational context for billing and revenue cycle teams, formulary and pharmacy committees, and clinical leaders responsible for protocols involving human albumin. Data not available in the input is noted explicitly where applicable in detailed sections of the full publication.
Billing Code Overview
HCPCS Level II code P9047 describes infusion of human albumin, 25%, 50 ml. This code denotes administration of a concentrated albumin solution derived from human plasma, delivered intravenously to provide volume expansion, oncotic support, or replacement of plasma proteins.
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Service type: Intravenous infusion of a blood-product–derived albumin preparation
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Typical site of service: Hospital inpatient or outpatient infusion center, emergency department, or other clinical settings capable of intravenous therapy
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with decompensated cirrhosis and clinically significant hypoalbuminemia is admitted for management of ascites and hypotension. The clinician orders intravenous human albumin 25% to restore intravascular oncotic pressure after large-volume paracentesis or to treat hepatorenal syndrome. The therapy is administered as P9047 (Infusion, albumin (human), 25%, 50 ml) in an outpatient infusion center or inpatient hospital setting. Pre-infusion steps include verification of indication and consent, review of allergies and prior albumin exposure, baseline vital signs and weight, and calculation of dose based on patient status. During infusion, nursing monitors for allergic reactions, volume status, and hemodynamics; documentation includes lot number, volume infused, start and stop times, and patient response. Post-infusion assessment includes repeat vital signs, evaluation for fluid overload or pulmonary edema, and instructions for follow-up labs (serum albumin, electrolytes, renal function). Typical sites of service are an outpatient infusion center, hospital inpatient unit, or emergency department observation area depending on acuity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when additional complexity or time for infusion beyond usual is documented (rare for standard albumin infusion). |