Summary & Overview
HCPCS C9293: Injection, Glucarpidase, 10 Units
HCPCS Level II code C9293 denotes the injection of glucarpidase, reported per 10-unit increment. Glucarpidase is an enzyme used in acute clinical scenarios to rapidly reduce toxic methotrexate levels, making timely billing and coding important for hospital and acute-care providers. Nationally, correct use of C9293 affects charge capture, reimbursement for high-cost specialty therapies, and administrative workflows in infusion and acute settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for glucarpidase administration, the typical sites where this service is provided, and the implications for hospital service lines and pharmacy/infusion billing. The publication also summarizes common billing modifiers associated with this code (listed separately), and indicates where input data was not available.
The content that follows provides benchmarks and coding considerations, payer coverage patterns, and common billing modifiers for C9293. It highlights operational considerations for documenting units administered and service lines responsible for charging. Data not provided in the input are noted as such in the relevant sections.
Billing Code Overview
HCPCS Level II code C9293 represents Injection, glucarpidase, 10 units. This code is used to bill for administration of the enzyme glucarpidase in quantified 10-unit increments.
Service Type: Medication administration / Injectable biologic therapy
Typical Site of Service: Hospital inpatient or outpatient infusion settings, emergency department, or other acute care facilities
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient with acute, severe methotrexate toxicity following high-dose methotrexate therapy for osteosarcoma is admitted to the hospital. The patient develops rapidly rising plasma methotrexate levels and acute kidney injury with delayed clearance, placing them at high risk for life-threatening myelosuppression and mucositis. The oncology team orders C9293 (injection, glucarpidase, 10 units) to enzymatically lower circulating methotrexate levels. The clinical workflow includes confirmation of elevated serum methotrexate concentration and renal impairment, informed consent, verification of dose and timing (typically a single IV bolus based on weight), administration by an oncology infusion nurse or inpatient pharmacist under the supervision of the treating oncologist, monitoring for allergic reactions, and serial methotrexate and renal function measurements post-administration. Supportive measures such as leucovorin rescue, hydration, urine alkalinization, and monitoring for myelosuppression continue concurrently. Documentation in the medical record includes indication, dose, lot number, route, time, supervising provider, and clinical response.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unmodified claim | When no modifier is required or no specific circumstances apply |