2025 HCPCS code J3590
(Active) Effective Date: N/A Revision Date: N/A Drugs - Unclassified Biologics Drugs, Administered by Injection Feed
This HCPCS code represents unclassified biologics administered via injection.It's used when no other specific code exists.
Modifiers may be applicable depending on the circumstances of service and payer guidelines. Consult current coding guidelines and payer-specific requirements.
Medical necessity for J3590 depends on the specific unclassified biologic and the patient's diagnosis.Documentation must support the medical need for the drug in the context of the patient's condition and treatment plan.
The provider administering the unclassified biologic is responsible for accurate coding and documentation. They must ensure the drug's identification and the method of administration are correctly represented.
In simple words: This code is for medicines made from living things (like cells or proteins) that don't have their own specific billing code.The doctor injects this medicine, and you need to give the pharmacy's code number (NDC) and details about the medicine used.
HCPCS code J3590 is used to report biologics (medicinal products derived from living organisms or their components) administered via injection when a more specific code isn't available. Biologics encompass a broad range of substances, including serums, vaccines, antigens, antitoxins, cells, genes, tissues, recombinant proteins, allergens, and blood components.Examples of biologic drugs include antibodies, interleukins, and vaccines.To ensure accurate billing, complete and detailed documentation is crucial, including the drug's National Drug Code (NDC) number, name, dosage, strength, number of doses per vial (if applicable), and amount per unit.This code represents the drug itself, not its administration.Check individual payer guidelines to determine if separate coding for administration is necessary; alternatively, codes like J3490 (unclassified drugs) or J9999 (unclassified neoplastic drugs) might be applicable depending on the specific drug and payer requirements.Prior authorization may be required by some payers for certain biologics.
Example 1: A patient with paroxysmal nocturnal hemoglobinuria (PNH) receives ravulizumab-cwvz (Ultomiris) intravenously.J3590 is used because there isn't a specific HCPCS code for this drug., A patient with relapsing multiple sclerosis receives ublituximab-xiiy (Briumvi) intravenously. Because no specific code exists for this biologic, J3590 is used for billing., A patient receives an experimental biologic medication for a clinical trial.Given the lack of established codes, J3590 is used to represent the administered drug, coupled with detailed documentation of the medication and administration.
* Drug's National Drug Code (NDC) number* Drug name* Dosage and strength* Number of doses per vial (if applicable)* Amount of drug per unit* Route of administration (intravenous)* Diagnosis code(s)
** Always verify payer-specific requirements and coding guidelines before submitting claims for J3590.Thorough documentation is essential to justify medical necessity and ensure accurate reimbursement.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is generally not applicable to J3590 as it represents the drug itself, not the administration. However, this should be verified with payer guidelines.
- Fee Schedule : Fee schedules vary by payer and are subject to change. Consult your payer's fee schedule for the most up-to-date reimbursement rates.
- Specialties:* Hematology/Oncology* Rheumatology* Immunology* Neurology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center