Summary & Overview
HCPCS Level II C9058: Pegfilgrastim-bmez (Ziextenzo) 0.5 mg Injection
HCPCS Level II code C9058 identifies the biosimilar pegfilgrastim-bmez (Ziextenzo) 0.5 mg injection, a long-acting granulocyte colony-stimulating factor used to decrease the risk of infection in patients undergoing myelosuppressive chemotherapy. As biologic therapies and biosimilars expand, accurate coding for pegfilgrastim biosimilars has implications for billing, formulary placement, and utilization tracking across outpatient oncology settings nationwide.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage considerations, billing benchmarks where available, and the clinical context for using pegfilgrastim biosimilars during chemotherapy cycles.
Readers will learn what C9058 represents clinically and operationally, typical sites of service where the injection is administered, and the types of benchmarks and policy updates that affect reimbursement and utilization. The document also summarizes how this HCPCS Level II code fits within biologic and biosimilar billing workflows and highlights areas where organizations commonly seek clarification. Data not available in the input will be noted as such in relevant sections.
Billing Code Overview
HCPCS Level II code C9058 represents injection, pegfilgrastim-bmez, biosimilar, (Ziextenzo) 0.5 mg. This code describes a single-dose biologic injection of pegfilgrastim-bmez, a biosimilar to pegfilgrastim used to reduce the duration of neutropenia and the incidence of infection in patients receiving myelosuppressive chemotherapy.
Service type: Therapeutic biologic injection
Typical site of service: Outpatient clinic, oncology infusion center, or outpatient hospital setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient receiving myelosuppressive chemotherapy for solid tumor or hematologic malignancy who requires prophylaxis against febrile neutropenia. The patient presents to an outpatient oncology infusion center or an ambulatory clinic for a same-day or next-day subcutaneous injection of pegfilgrastim-bmez (Ziextenzo) following a chemotherapy cycle. The nursing workflow includes verification of the chemotherapy administration and indication, review of allergies and prior adverse reactions to colony-stimulating factors, confirmation of renal and hepatic status as clinically indicated, patient education about injection-site reactions and signs of fever, preparation of the pre-filled syringe or single-dose vial containing 0.5 mg increments per the product labeling, administration of the subcutaneous injection (typically in the upper arm, thigh, or abdomen), observation for immediate adverse reactions, documentation of lot number and expiration, and billing using HCPCS Level II code C9058 for the specific biosimilar product. Typical sites of service include outpatient hospital infusion centers, physician offices (oncology clinics), and freestanding oncology ambulatory treatment centers. The common scenario: a patient who completed a cycle of cytotoxic chemotherapy the previous day returns for pegfilgrastim-bmez to reduce duration of chemotherapy-induced neutropenia and lower risk of febrile neutropenia, with nursing documentation and billing performed at the visit.
Coding Specifications
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