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2025 HCPCS code J1640

Injection, hemin, 1 mg

This code represents only the supply of hemin. The administration of the drug may be reported separately depending on payer guidelines. Check specific payer policies for coding and reimbursement rules.

Modifiers may be applicable depending on the circumstances of administration and payer-specific guidelines.

Hemin is medically necessary for the treatment of acute attacks of porphyria. The medical record should document the clinical presentation, including specific symptoms and their severity, to support the need for hemin administration.

In simple words: Hemin is a drug injected to control symptoms during sudden porphyria flare-ups. Porphyria is a condition causing problems with hemoglobin, the part of red blood cells carrying oxygen. Hemin helps by lowering the production of certain natural substances in the body. Each unit of this code equals 1 mg of the drug. This code only covers the drug cost, not the injection itself.

Hemin is administered via injection to manage symptoms of acute porphyria attacks. It reduces the body's production of specific enzymes involved in heme synthesis. This code represents 1 mg of hemin and covers only the drug itself, not its administration.

Example 1: A patient presents to the ER with an acute attack of porphyria, experiencing severe abdominal pain, increased heart rate, and neurological symptoms. Hemin is administered intravenously to alleviate symptoms and stabilize the patient's condition., A patient with a history of acute intermittent porphyria experiences prodromal symptoms and is admitted for observation. Hemin treatment is initiated early to prevent a full-blown attack and minimize symptom severity., A patient with variegate porphyria is admitted for treatment of a severe, recurrent attack. Hemin is administered intravenously over several days to manage symptoms, along with supportive care.

Documentation should include diagnosis of porphyria type, signs and symptoms of acute attack, dosage of hemin administered, route of administration, and medical necessity for the treatment.

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