Summary & Overview
HCPCS C9480: Injection, trabectedin, 0.1 mg
HCPCS Level II code C9480 designates the drug and unit for trabectedin injection (0.1 mg). Trabectedin is an antineoplastic agent used in oncology infusion settings; the HCPCS code standardizes billing for the drug unit across outpatient infusion centers, hospital outpatient departments, and oncology clinics. Nationally, accurate coding for high-cost cancer therapies matters for claims adjudication, utilization tracking, and patient cost-sharing calculations.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how C9480 is used in clinical and billing workflows, typical sites of service, and what to expect when documenting usage of trabectedin by the 0.1 mg unit measure. The publication also provides benchmarking context and policy-relevant considerations for national payers and billing teams.
The report summarizes available benchmarks, payer coverage patterns, and recent policy updates that affect antineoplastic drug billing. Clinical context for trabectedin administration, including service line implications for oncology infusion and outpatient settings, is presented to help coding and revenue teams align documentation with billing. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C9480 represents Injection, trabectedin, 0.1 mg. This code describes the administration and drug supply for trabectedin in a quantified unit of 0.1 mg.
Service Type: Chemotherapy drug administration / Parenteral antineoplastic therapy
Typical Site of Service: Outpatient infusion center, oncology clinic, or hospital outpatient department
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old female with metastatic soft tissue sarcoma presents to an outpatient oncology infusion center for administration of trabectedin. The patient has progressed on prior anthracycline-based therapy and is scheduled to receive intravenous C9480 (Injection, trabectedin, 0.1 mg) administered by oncology nursing under a medical oncologist’s supervision. Pre-infusion evaluation includes vital signs, laboratory review (CBC, liver function tests, renal function), and assessment for infusion-related reactions. The workflow includes medication preparation by pharmacy (dose calculated per body surface area), verification of the provider order, premedication per protocol (antiemetic, corticosteroid if indicated), infusion via peripheral IV or central venous access over the recommended infusion time, post-infusion observation for adverse events, and documentation of dose, lot number, route, site of administration, and any modifier(s) or diagnosis codes linked to the claim. Typical sites of service are hospital outpatient infusion centers or freestanding oncology infusion clinics.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when a separate, distinct service or procedure unrelated to the primary infusion is performed on the same day and must be reported separately. |