Summary & Overview
HCPCS J1442: Filgrastim (G-CSF) Injection, 1 Microgram
HCPCS Level II code J1442 denotes an injectable dose of filgrastim (granulocyte colony-stimulating factor), billed per 1 microgram and excluding biosimilars. Filgrastim is widely used to prevent or treat neutropenia associated with chemotherapy, bone marrow transplantation, and other conditions that suppress bone marrow function. As a physician-administered biologic, billing for J1442 is relevant across outpatient infusion centers, physician offices, and hospital outpatient departments, affecting clinical workflows and drug spend nationally.
Major payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what J1442 represents clinically, typical sites of service, common billing modifiers, and payer coverage considerations. The publication summarizes benchmark payment contexts, potential policy updates affecting biologic drug billing, and clinical indications tied to filgrastim use.
This analysis is intended for national audiences involved in revenue cycle, pharmacy, and clinical operations. It provides a clear reference for coding J1442, situating the code within therapeutic injection services and outpatient biologic administration.
Billing Code Overview
HCPCS Level II code J1442 represents an injection of filgrastim (G-CSF), billed per 1 microgram and excluding biosimilars. The code is used for administration of the granulocyte colony-stimulating factor filgrastim, a biologic agent that stimulates neutrophil production.
Service Type: Therapeutic injection / drug administration
Typical Site of Service: Outpatient infusion or injection setting, including hospital outpatient departments, physician offices, and infusion centers.
Clinical & Coding Specifications
Clinical Context
A 62-year-old female receiving myelosuppressive chemotherapy for metastatic breast cancer presents to the outpatient oncology infusion clinic for supportive care. Her oncologist prescribes prophylactic granulocyte colony-stimulating factor to reduce the risk of febrile neutropenia after recent cycle counts showed an absolute neutrophil count trending downward and planned dose-dense therapy is scheduled. Nursing verifies allergies and recent labs, prepares a syringe containing filgrastim, documents lot number and dose, and administers a subcutaneous injection in the clinic. The clinic documents the administration using billing code J1442 (filgrastim, excludes biosimilars, 1 microgram) multiplied by the number of micrograms administered. Typical workflow includes medication reconciliation, verification of the order, patient education about injection-site care and adverse effects, medication administration record entry, and documentation of the lot and expiration. Typical site of service is an outpatient infusion center, oncology clinic, or physician office where injectable supportive therapies are provided. Ancillary services may include nursing administration (reported by facility or provider based on payer rules) and concurrent billing for chemotherapy administration or evaluation and management services when medically appropriate and permitted by payer policy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered |