Summary & Overview
HCPCS J1190: Injection, dexrazoxane hydrochloride, per 250 mg
HCPCS Level II code J1190 denotes the injection of dexrazoxane hydrochloride, billed per 250 mg unit. Dexrazoxane is a cardioprotective agent commonly used in oncology to mitigate anthracycline-induced cardiotoxicity and is administered intravenously in infusion settings. Nationally, accurate coding for specialty oncology drugs like dexrazoxane affects coverage determinations, claims processing, and cost reporting across public and commercial payers.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical sites of service, and what aspects of reimbursement and billing workflows are commonly associated with high-cost injectable oncology agents. The publication outlines benchmarks for unit-based drug billing, relevant payer coverage considerations, and common claim line practices where available. Where specific payer policy details or comparative rates are not provided, the text notes that data is not available in the input.
This summary equips health system revenue leaders, oncology clinic billing staff, and policy analysts with the baseline information needed to identify when J1190 should appear on a service line, how the code is classified, and which stakeholders typically engage with coverage decisions for dexrazoxane.
Billing Code Overview
HCPCS Level II code J1190 describes an injection of dexrazoxane hydrochloride, measured per 250 mg. This code represents the drug product and its administration billing descriptor rather than a specific procedure or visit type.
Service Type: Medication administration (intravenous)
Typical Site of Service: Hospital outpatient infusion center, oncology clinic, or ambulatory infusion center, where intravenous cytoprotective therapy is provided.
Clinical & Coding Specifications
Clinical Context
A 58-year-old female receiving anthracycline chemotherapy for metastatic breast cancer presents for scheduled administration of a cardioprotective agent prior to doxorubicin infusion. The oncology nurse verifies weight-based dosing, prepares dexrazoxane hydrochloride, and documents pre-medication consent. The medication J1190 (injection, dexrazoxane hydrochloride, per 250 mg) is administered intravenously by infusion pump 30 minutes before the anthracycline to reduce cumulative dose-related cardiotoxicity. Vital signs and infusion site are monitored during and after administration. Medication lot, dose, and billing information are captured in the electronic medical record and transmitted to the payer. Typical site of service is an outpatient oncology infusion center or hospital outpatient infusion clinic. Common supporting services include pharmacy preparation, nursing administration, and chemotherapy order verification by the oncologist.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug Quantity Discarded | When a portion of a single-use vial of dexrazoxane is discarded and must be reported per payer policy |
JZ |