Summary & Overview
HCPCS C9028: Injection, Inotuzumab Ozogamicin, 0.1 mg
HCPCS Level II code C9028 represents the injectable antineoplastic agent inotuzumab ozogamicin dosed per 0.1 mg. This code is used to report administration of a targeted oncology therapy delivered via injection or infusion and is relevant for hospitals, physician practices, and ambulatory infusion centers nationwide. Accurate coding for high-cost oncology agents like inotuzumab ozogamicin affects billing, utilization tracking, and payer coverage determinations.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for C9028, typical sites of service, and what to expect in payer coverage patterns. The publication provides benchmarks for utilization and reimbursement where available, notes recent policy developments affecting injectable oncology biologics, and summarizes coding considerations specific to HCPCS Level II reporting.
The analysis is intended for clinical coders, billing professionals, and revenue management teams seeking clear, actionable information about how C9028 is represented in billing workflows and payer interactions. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code C9028 represents Injection, inotuzumab ozogamicin, 0.1 mg. This code describes a parenteral oncologic medication administered as a measured-dose injectable product.
Service type: Therapeutic injectable (antineoplastic/targeted therapy)
Typical site of service: Hospital outpatient department, physician office, or infusion center (ambulatory infusion setting)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) presents for outpatient intravenous administration of targeted antibody-drug conjugate therapy. The oncology clinic verifies recent labs (CBC, liver function tests), obtains informed consent, and performs baseline vital signs and premedication per protocol. The medication is prepared by pharmacy as C9028 (inotuzumab ozogamicin, 0.1 mg vial). A certified oncology nurse places an IV line or uses an implanted port, confirms identity and infusion parameters, and administers the calculated dose over the prescribed infusion time in an infusion center or hospital outpatient infusion suite. The patient is monitored for infusion-related reactions, hepatic toxicity, and cytopenias during and after infusion. Post-infusion documentation includes medication lot number, vial units administered, site of service, any modifier usage such as 51 for multiple components on a single claim, and appropriate ICD-10 diagnosis linking the administration to the underlying hematologic malignancy. Typical site of service: outpatient oncology infusion center or hospital outpatient department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple procedures | When more than one distinct procedure or HCPCS/CPT is billed on the same date of service and payer requires the modifier to indicate multiple procedures |