2025 HCPCS code J7203

One unit of J7203 represents 1 IU of Rebinyn® (glycopegylated, recombinant coagulation factor IX) administered intravenously to treat hemophilia B.

Refer to HCPCS coding guidelines and individual payer policies for specific requirements and limitations regarding billing and reimbursement for Rebinyn® administration. Ensure proper documentation to support medical necessity.

Modifiers may apply depending on the circumstances of service; review payer specific guidelines for accepted modifiers.

Administration of Rebinyn® is medically necessary for the treatment and prevention of bleeding episodes in patients with hemophilia B.The specific dosage and timing will be determined by the physician based on the patient's clinical condition and the severity of bleeding.

Administration of Rebinyn® intravenously, appropriate dosage determination based on patient's condition and bleeding severity, monitoring patient response to treatment.

In simple words: This code is for a specific medicine called Rebinyn, given through an IV to treat hemophilia B (a bleeding disorder). The doctor decides how much medicine is needed based on the severity of the bleeding.

J7203 represents one international unit (IU) of Rebinyn® (glycopegylated, recombinant coagulation factor IX) administered via intravenous infusion. This medication is used to treat hemophilia B in both adult and pediatric patients.Its applications include on-demand treatment and control of bleeding episodes, as well as perioperative bleeding management.Dosage recommendations vary depending on the severity of bleeding and the type of surgical procedure (if applicable). For example, the recommended dose for on-demand treatment ranges from 40 IU/kg for minor/moderate bleeds to 80 IU/kg for major bleeds. Perioperative management may require preoperative doses of 40-80 IU/kg, with potential for repeated doses post-surgery as clinically indicated.

Example 1: A 10-year-old boy with hemophilia B experiences a moderate bleeding episode following a fall.The physician administers Rebinyn® intravenously at a dose of 40 IU/kg to control the bleeding., An adult male with hemophilia B is scheduled for a major surgical procedure. The surgeon administers Rebinyn® intravenously preoperatively at a dose of 80 IU/kg, and additional doses are administered postoperatively as needed to manage bleeding and promote healing., A young adult female with hemophilia B has a minor bleeding episode. The physician administers Rebinyn® intravenously at a dose of 40 IU/kg, and monitors her clotting factors to assess the efficacy of treatment.

Complete patient history including diagnosis of hemophilia B, details of bleeding episode (location, severity, duration), weight of the patient, dosage of Rebinyn® administered, date and time of administration, route of administration, physician's assessment of response to therapy, any adverse reactions, and documentation supporting medical necessity.

** This code should only be used for the Rebinyn® brand of factor IX.If only a portion of a vial is used, and the remainder discarded, modifier JW might be applicable (check payer guidelines).The administration of the drug may require separate billing codes depending on payer rules.

  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Specialties:Hematology, Hemophilia Centers
  • Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center
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