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    v1.0.31
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0870-imetelstat-injection-1mg
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    HCPCS Level II J0870: Injection, imetelstat, 1 mg

    HCPCS Level II code J0870 denotes a billed injection of imetelstat, 1 mg, typically reported for administration of the antineoplastic agent; the service type is an injectable chemotherapy or immunotherapy drug dose delivered in an outpatient infusion or oncology clinic setting.

    For related coverage guidance, see recent payer policy updates: Bendamustine Products Coverage Criteria, T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Brentuximab Vedotin (Adcetris®) Coverage Criteria.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient receiving J0870 (imetelstat, 1 mg) is an adult with a myeloid malignancy such as myelodysplastic syndromes (MDS) or myeloproliferative neoplasm (MPN) who requires parenteral, weight- or dose-based cytotoxic therapy administered in an outpatient oncology clinic or infusion center. The clinical workflow begins with a hematology/oncology evaluation documenting diagnosis, prior therapies, performance status, baseline labs (CBC with differential, comprehensive metabolic panel, liver function tests), and informed consent for chemotherapy. On day of treatment, the patient undergoes pre-infusion assessment (vital signs, review of labs for cytopenias and hepatic function), intravenous access placement (peripheral IV or central line), and administration of pre-medications if indicated (antiemetic or supportive agents per institutional protocol). Pharmacy verifies the J0870 dose and prepares the medication under sterile compounding conditions. Nursing performs infusion and monitors for acute infusion reactions, cytopenias, or other adverse events. Post-infusion monitoring includes vital signs, documentation of any immediate reactions, and scheduling of follow-up labs and hematology visits to assess response and toxicity. Typical sites of service are outpatient hospital infusion centers, physician office infusion suites, and specialized oncology clinics. Inpatient administration may occur for severe complications or when admission is required for concurrent care.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96413Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drugCommonly billed for the infusion time associated with administration of J0870 when infusion duration fits the time criteria.
    96415Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary infusion)Used when infusion of J0870 and supportive agents extends beyond the first hour and additional time is billed.
    96401Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplasticUse if alternative route (non-IV) is applicable, though J0870 is typically IV.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesBilled for the outpatient follow-up or pre-infusion evaluation by the provider when applicable.
    96409Chemotherapy administration, intravenously, each additional sequential infusion of a new drug, up to 1 hourUsed when multiple sequential infusions occur during the same encounter in addition to the primary drug infusion.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    363L00000X
    163W00000X
    367A00000X
    111NR0200X
    163WC0400X
    3245S0500X
    2080P0216X

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    C91.10Chronic lymphocytic leukemia of B-cell type not having achieved remission
    C91.12Chronic lymphocytic leukemia of B-cell type in relapse
    C94.6Myelodysplastic disease, not elsewhere classified
    C95.10Chronic leukemia of unspecified cell type not having achieved remission
    C95.11Chronic leukemia of unspecified cell type, in remission
    D46.4Refractory anemia, unspecified
    D46.9Myelodysplastic syndrome, unspecified
    D47.1Chronic myeloproliferative disease
    D47.2Monoclonal gammopathy
    D61.9Aplastic anemia, unspecified

    Showing 1–10 of 21

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Bendamustine Products Coverage Criteriablue cross blue shield - tennessee2027-01-30
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Brentuximab Vedotin (Adcetris®) Coverage Criteriablue cross blue shield - tennessee2026-12-31
    Pemetrexed Coverageblue cross blue shield - tennessee2026-12-31
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    VonvendiCigna2026-11-15
    Hematology - AphexdaCigna2026-11-15
    Extracorporeal PhotopheresisCigna2026-11-15
    Yartemlea (narsoplimab-wuug) Coverage for TA-TMANeighborhood Health Plan of Rhode Island2026-11-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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