J9043 Leads the Pack of Novel Chemotherapy Codes for 2012

The 2012 examples demonstrate which novel drug code you're likely to pair with a push admin code.

HCPCS has three all new J9xxx codes offered for 2012 dates of service. If you run HCPCS code search, you will find that Jevtana, Halaven, and Yervoy all of these now have definite codes you can report when your practice supplies those drugs. Read this article for accurate HCPCS medical coding.

How to prepare? Ensure that you update your charge master, electronic dictionaries, as well as charge slips to reflect any code and/or unit changes. In case drug unit calculations are carried out electronically, make certain that those fields are current in the charge master or electronic billing system so the quantity is appropriately reflected in billing.

Smart move: The code changes are effective Jan. 1, 2012, so complete your updates along with education before that date to exclude errors

J9043 Applies to New Prostate Cancer Treatment

Cabazitaxel will get a definite code for 2012: J9043, Injection, cabazitaxel, 1 mg. If you run a HCPCS code search, you will find that there was no exclusive HCPCS code to report cabazitaxel in 2011.

The brand name you'll see related with this anti-cancer medication is Jevtana. Physicians order it, normally together with daily oral prednisone, for treating metastatic prostate cancer that has progressed despite previous treatments, with docetaxel (J9171, Injection, docetaxel, 1 mg).

2012 example: Thirty minutes after the patient takes oral pre-medications (antihistamine, corticosteroid, and H2 antagonist), staff governs 47.25 mg of Jevtana via 1-hour infusion. You must report 48 units of J9043 for the Jevtana supply as well as 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) for the administration.

Expect to Pair J9179 With IV Push Code

In case your practice provides Halaven injections, take note of novel code J9179 (Injection, eribulin mesylate, 0.1 mg). If you run a HCPCS code search, you will find that Eribulin mesylate also did not have an exclusive code in 2011.

Physicians might order eribulin mesylate (sold as Halaven) to treat locally advanced or metastatic breast cancer in patients who have previously received at least two chemotherapeutic regimens, with an anthracycline and a taxane.

2012 example: Staff gives 2.41 mg of Halaven by a 4-minute IV push. You must report the supply with 25 units of J9179, and report the administration by the means of 96409 (Chemotherapy administration; intravenous, push technique, single or initial substance/drug).

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HCPCS Says Yes to J9228 for Yervoy

You'll also have a novel 2012 CPT code for ipilimumab, which is sold as Yervoy: J9228, Injection, ipilimumab, 1 mg. If you run a HCPCS code search, you will find that it did not offer a distinct code for ipilimumab in 2011.

2012 example: Staff gives 210.93 mg of Yervoy via a 90-minute IV infusion. You must report 211 units of J9228 for the drug. For the administration you must report 96413, which covers the first hour plus up to an additional 30 minutes of administration time, a total of 90 minutes. (CPT® requires at least 31 additional minutes to report +96415, ... each additional hour [List separately in addition to code for primary procedure], so you should not report +96415 in this example which involves a 90-minute infusion).