Summary & Overview
HCPCS C9082: Injection, dostarlimab-gxly, 100 mg
HCPCS Level II code C9082 denotes the 100 mg injectable presentation of dostarlimab-gxly, an anti–PD-1 monoclonal antibody used in oncology treatment regimens. As a drug-specific HCPCS Level II code, C9082 is used to report the administered unit of the biologic product for billing across outpatient infusion settings. Nationally, accurate use of this code affects provider reimbursement, drug utilization tracking, and claims adjudication for high-cost immunotherapy agents.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides clinicians, billing professionals, and policy staff with a concise reference on coding practice and payer coverage considerations for C9082.
Readers will learn: the clinical context for use of dostarlimab-gxly, typical sites of service where the product is administered, common billing considerations including unitization and service-line placement, and an overview of payer coverage patterns and policy updates where available. Data not available in the input will be clearly identified as such elsewhere in the full publication.
Billing Code Overview
HCPCS Level II code C9082 represents injection, dostarlimab-gxly, 100 mg. This code describes a single unit of the anti–PD-1 monoclonal antibody formulation dosed as a 100 mg injectable product.
Service type: Pharmaceutical administration / infused or injected oncology biologic
Typical site of service: Outpatient infusion center, oncology clinic, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with recurrent or advanced mismatch repair-deficient (dMMR) endometrial carcinoma is scheduled to receive intravenous immunotherapy with dostarlimab-gxly. The therapy is administered as an infusion in an outpatient oncology infusion center by an oncology nurse under the supervision of a medical oncologist. Prior to administration, the patient undergoes verification of identity, review of recent labs (including CBC and CMP), assessment for infusion reaction history, and confirmation of dosing per weight or fixed-dose protocol. The infusion encounter includes medication preparation by pharmacy, verification of prior authorization and benefits with payors, and documentation of lot number and dose administered. Typical supportive care during and after infusion includes vital sign monitoring, infusion reaction management supplies at bedside, and patient education regarding immune-related adverse events and when to contact the clinic. Follow-up visits for toxicity assessment and treatment response are scheduled at regular intervals, and subsequent doses are documented similarly using the HCPCS Level II billing code C9082 per 100 mg increment as applicable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use if unusually extensive clinical work or documentation increasing resource use for the infusion encounter beyond typical time or complexity. |