Summary & Overview
HCPCS C9170: Injection, tarlatamab-dlle, 1 mg
HCPCS Level II code C9170 denotes the administration unit for tarlatamab-dlle, recorded as Injection, tarlatamab-dlle, 1 mg. As a drug-specific HCPCS Level II code, C9170 standardizes claims for dosing and billing of this oncologic biologic across outpatient infusion and clinic settings. Nationally, drug-specific HCPCS codes matter for consistent reimbursement, inventory tracking, and formulary management for specialty therapies.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of how the code is used in billing lines for parenteral biologic administration, the typical sites of service where claims are submitted, and the payer landscape relevant to this HCPCS Level II code. The publication also provides benchmarks where available, notes on common billing modifiers, and contextual clinical considerations tied to tarlatamab-dlle dosing units.
This summary is intended for billing managers, revenue cycle analysts, and clinical administrators seeking a national overview of code C9170, its clinical identity as a tarlatamab-dlle injection measured per milligram, and the payer environment that influences claims processing and coverage decisions.
Billing Code Overview
HCPCS Level II code C9170 represents Injection, tarlatamab-dlle, 1 mg. This billing code covers administration of the specified monoclonal antibody formulation measured per milligram.
-
Service type: Drug administration (parenteral oncologic biologic)
-
Typical site of service: Hospital outpatient department, infusion center, or clinic setting where intravenous or subcutaneous oncologic injections are provided.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with relapsed or refractory small cell lung cancer (SCLC) presents to an outpatient oncology infusion center for administration of the investigational bispecific T‑cell engager C9170 (injection, tarlatamab‑dlle, 1 mg). The patient has a recent oncology clinic visit documenting progressive disease after prior platinum‑based chemotherapy and immunotherapy, baseline labs within acceptable limits, and an informed consent discussion about risks, benefits, and monitoring for cytokine release syndrome (CRS) and immune‑related adverse events. The clinical workflow includes pre‑infusion verification of the medication order, dose calculation by weight or body surface area if applicable, pharmacy preparation and labeling of the tarlatamab‑dlle syringe(s), nursing time for IV line placement and infusion setup, vital sign monitoring during and after infusion per protocol, and documentation of the administered milligrams using billing code C9170 per milligram unit. Immediate post‑infusion observation for infusion reactions and scheduled follow‑up visits for response assessment and ongoing toxicity monitoring are part of routine care. Typical sites of service include outpatient hospital infusion centers and ambulatory oncology clinics specializing in systemic cancer therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |