Summary & Overview
HCPCS G3001: Administration and Supply of Tositumomab, 450 mg
HCPCS Level II code G3001 denotes the administration and supply of tositumomab, 450 mg. The code identifies provision of a specific oncologic therapeutic agent and is relevant for billing in outpatient infusion settings and hospital clinics. Nationally, accurate coding for specialty oncology drugs affects claims processing, prior authorization workflows, and payment consistency for high-cost biologic therapies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical context and service setting, an overview of payer coverage patterns, and benchmarks for how this HCPCS Level II code is categorized in provider billing systems. The publication also highlights policy considerations that influence reimbursement for specialty oncology drugs and outlines commonly reported service-line contexts where G3001 appears.
The report is intended for billing managers, oncology practice administrators, and policy analysts seeking a practical reference to the code's clinical purpose, typical sites of service, and the payers most likely to be involved in coverage decisions.
Billing Code Overview
HCPCS Level II code G3001 represents the administration and supply of tositumomab, 450 mg. This code describes a therapeutic infusion or injectable oncology agent delivered as a single-dose supply of tositumomab at a 450 mg quantity.
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Service type: Drug administration and supply
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Typical site of service: Infusion center or outpatient hospital clinic
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with CD20-positive non-Hodgkin lymphoma refractory to or relapsed after prior therapies who is scheduled to receive radioimmunotherapy with the monoclonal antibody tositumomab. The clinical workflow begins with oncology evaluation and staging, confirmation of CD20 expression, and baseline laboratory studies including CBC, renal and hepatic panels, and viral serologies. On day of service, the patient arrives to an outpatient oncology infusion center or hospital outpatient department for administration of G3001 (tositumomab, 450 mg). Pre-medication to reduce infusion reactions is given per institutional protocol. The nurse performs IV access verification, medication verification, and vital signs monitoring. The provider documents indication, consent, and infusion parameters; the pharmacy verifies dose and prepares the drug under sterile conditions. Post-infusion observation is performed for infusion-related reactions; follow-up includes schedule for any subsequent radioisotope administration if part of a combined radioimmunotherapy protocol, and routine oncology follow-up for response assessment and toxicity monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a same-day E/M visit is performed and documented separately from the infusion administration for . |