HCPCS Code J2507: Injection, Pegloticase, 1 mg

Learn about the J2507 HCPCS code for injection, pegloticase, 1 mg through this short guide.

## **What is the HCPCS code J2507 for?** The HCPCS code J2507 designates the injection of pegloticase, specifically a dose of 1 mg. It is a J code, which is an HCPCS code for injections. It is commonly referred to as a pegloticase injection, and technically as an intravenous infusion of pegloticase. It is a drug administered intravenously by a registered nurse, with direct supervision from another nurse practitioner or physician. This cannot be self-administered. The purpose of this intravenous injection is to lower the patient's uric acid levels in their bloodstream. It is often used as one of the last resorts to treat a patient with chronic gout, only when other forms of treatment have failed. Not only will this medicine lower uric acid levels, but it will also help prevent gout from damaging joints and reduce the likelihood of flare-ups.

## **Documentation requirements for J2507** As with any procedure, especially involving injecting drugs into patients, it's important to document the following before you file for a claim that includes this code: - The full name of the personnel who administered the injection + their credentials - The name and address of the facility where the injection was administered - The full name of the patient - The date and time of the drug administration by injection - Patient records showing they have been diagnosed with gout - Patient records showing a history of gout - Blood test results showing uric acid levels in the blood stream - Record of medications used to combat gout, which ones have worked, and which ones didn't - The medical necessity of this injection - The exact dosages and routes

## **Billing requirements for J2507** Besides the documentation requirements above, please note the following billing requirements for this HCPCS code: - They must reflect the dosage given over the course of the treatment. - Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication. Since this is an intravenous injection, please also use CPT code 96365. Make sure to follow CMS/Medicare mandates to prevent claim rejections.

## **Other similar codes** - **J2507** - Injection, pegloticase, 1 mg - **J2503** - Injection, pegaptanib sodium, 0.3 mg - **J2505** - Injection, pegfilgrastim, 6 mg - **J2501** - Injection, paricalcitol, 1 mcg - **J2562** - Injection, plerixafor, 1 mg

Frequently asked questions

About 2 hours.

This can only be administered in an infusion center, an outpatient clinic, or hospital. This cannot be self-administered.

The patient will feel pain and discomfort in the injection site. They might also experience headaches and feel nauseous. Adverse effects, though rare, include severe allergic reactions and infusion reactions.