Summary & Overview
HCPCS C9464: Rolapitant Injection, 0.5 mg
HCPCS Level II code C9464 represents a billed injectable dose of rolapitant (0.5 mg). Rolapitant is an antiemetic used in oncology care to prevent chemotherapy-induced nausea and vomiting; assigning a unique HCPCS Level II code enables standardized billing for the parenteral formulation and supports consistent reporting across sites that administer infusible or injectable supportive medications. Nationally, precise coding for ambulatory oncology drugs affects reimbursement, inventory tracking, and clinical billing workflows.
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 rolapitant injection, typical sites of service where this code is billed, and what to expect in payer coverage patterns. The publication summarizes benchmark considerations for coding and billing, highlights relevant policy updates that commonly affect HCPCS-coded injectables, and provides operational notes for integration into outpatient and infusion workflows.
This summary is written for a national audience and focuses on how HCPCS Level II code C9464 is used in practice, why it matters to revenue cycle and clinical teams, and what aspects payers typically evaluate when adjudicating claims for injectable oncology supportive care.
Billing Code Overview
HCPCS Level II code C9464 — Injection, rolapitant, 0.5 mg — designates a billed injectable dose of the antiemetic agent rolapitant at a 0.5 mg strength. This code covers administration of a single quantified unit of rolapitant formulated for injection.
Service Type: Parenteral medication administration
Typical Site of Service: Infusion center, outpatient clinic, or hospital outpatient department
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient scheduled to receive antiemetic prophylaxis prior to moderately or highly emetogenic chemotherapy. The patient presents to an outpatient oncology infusion clinic. The oncology nurse verifies identity, reviews current medications, allergy status, and chemotherapy regimen, and documents prior nausea control. The clinician orders C9464 (injection, rolapitant, 0.5 mg) to be administered intravenously or as specified by product labeling as part of a multi-agent antiemetic regimen, usually before chemotherapy infusion. The medication is prepared by pharmacy in accordance with sterile handling and dosing specifications. The nurse administers the injection, monitors for acute adverse reactions for the recommended observation period, documents lot number, dose, route, time, and any immediate patient response, and provides post-administration instructions. Typical workflow includes billing C9464 as a drug/joint supply HCPCS Level II code on the claim form, linked to the chemotherapy administration encounter and the relevant ICD-10 diagnosis for the malignancy or for chemotherapy-related nausea prevention.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
24 | Unrelated evaluation and management service by the same physician during a postoperative period | When a clinically unrelated E/M occurs during a global period for the same provider on the infusion day |