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    v1.0.30
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j0897-denosumab-injection-1mg
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    HCPCS Level II J0897: Denosumab Injection, 1 mg

    HCPCS Level II code J0897 describes the billing entry for an injection of denosumab, 1 mg, typically administered as an injectable biologic medication for conditions requiring RANKL inhibition; the service type is drug administration (injectable therapy) and the typical site of service is an infusion clinic or outpatient office where parenteral biologic therapies are given.

    For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old postmenopausal woman with a history of osteoporosis and a recent fragility wrist fracture presents to the outpatient infusion clinic for administration of denosumab. The patient has dual-energy X-ray absorptiometry (DXA) confirming low bone mineral density and meets criteria for pharmacologic therapy. The clinic verifies allergies, recent calcium and vitamin D supplementation, and current serum calcium level prior to treatment. The registered nurse confirms informed consent and performs medication reconciliation, then prepares and administers the subcutaneous injection of denosumab. The encounter includes medication administration, post-injection observation for adverse reactions, documentation of lot number and dose, and scheduling of the next dose in six months.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96401Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplasticSometimes billed for complex subcutaneous biologic injections when local or payor rules require an administration code for injectable biologics (verify payor policy)
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscularCommonly used for reporting the professional administration service for a single subcutaneous injection like denosumab in an office setting
    99070Supplies and materials provided by the physician over and above those usually included with the office visitUsed to report separately billed supplies associated with injection administration when allowed by payor
    96360Intravenous infusion, hydration; initial, 31 minutes to 60 minutesNot directly related but may appear if the patient required IV therapy for an adverse event during the visit
    99213Office or other outpatient visit for the evaluation and management of an established patient, moderate severityCommon E/M code for pre-injection assessment, counseling, and follow-up planning when a significant E/M service is documented on the same day

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    208000000X
    363A00000X
    207K00000X
    2085B0100X
    3336I0012X
    1710I1002X
    207ZH0000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    C79.51Secondary malignant neoplasm of bone
    C79.52Secondary malignant neoplasm of bone marrow
    D49.9Neoplasm of unspecified behavior of unspecified site
    D64.9Anemia, unspecified
    E03.9Hypothyroidism, unspecified
    E83.30Disorder of phosphorus metabolism, unspecified
    F33.1Major depressive disorder, recurrent, moderate
    M05.79Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement
    M06.9Rheumatoid arthritis, unspecified
    M25.50Pain in unspecified joint

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    Electric Tumor Treatment Field Therapy (for Tennessee Only)Colorado Rocky Mountain Health Plans2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    OmisirgeCigna2026-11-01
    Hematology - AdzynmaCigna2026-10-15
    Transcatheter Arterial Chemoembolization for Liver Tumorspremerabluecrossofwashington2026-10-01
    Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bonepremerabluecrossofwashington2026-10-01

    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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