Summary & Overview
HCPCS J1434: Fosaprepitant (focinvez) Injection, 1 mg
HCPCS Level II code J1434 represents the intravenous injection of fosaprepitant (focinvez), billed per milligram. Fosaprepitant is an IV antiemetic used in supportive oncology care to prevent chemotherapy-induced nausea and vomiting; clear coding for this drug supports accurate pharmacy billing, benefit administration, and drug utilization tracking at a national level. The code matters for hospitals, infusion centers, and oncology clinics where IV antiemetic agents are administered alongside chemotherapy.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for fosaprepitant infusion, typical sites of service, and what to expect in payer coverage considerations nationally. The publication summarizes benchmarks and administrative considerations such as billing unit definitions, common site-of-service implications, and areas where policy updates or payer formularies commonly affect coverage. Where input data is incomplete, the report notes missing fields and focuses on universally applicable coding facts and clinical relevance for national audiences.
Billing Code Overview
HCPCS Level II code J1434 describes Injection, fosaprepitant (focinvez), 1 mg. This code identifies the administration of the intravenous antiemetic agent fosaprepitant, expressed per milligram. The service type is medication administration via injection, and the typical site of service is an outpatient infusion center or hospital outpatient department where IV antiemetic therapy is provided.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a adult oncology patient receiving emetogenic chemotherapy for solid tumor or hematologic malignancy who requires intravenous antiemetic prophylaxis. A chemotherapy nurse in an outpatient oncology infusion center prepares and administers J1434 (injection, fosaprepitant, 1 mg) as a single-dose IV infusion or as part of a multi-agent antiemetic regimen. The workflow: verification of chemotherapy orders and allergies, review of prior antiemetic response, dose calculation based on the prescribed fosaprepitant mg (converted from the vial strength), preparation under aseptic technique in the pharmacy or infusion suite, patient identity and IV access confirmation, administration via peripheral or central line over the recommended time, monitoring for infusion reactions and documenting lot number, dose, route, and any wastage. Typical sites of service include outpatient hospital infusion centers, physician office-based infusion suites, and ambulatory infusion centers. Common clinical scenarios include prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) for regimens with moderate to high emetogenic potential, and periprocedural use when guideline-directed NK1 receptor antagonist therapy is indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard submission indicating no special modifier applies |
| | Increased procedural services | Use when the administration required substantially greater effort or time than typical (document rationale) | Use when documentation supports unusually complex administration or extended monitoring