Summary & Overview
HCPCS J1626: Granisetron Hydrochloride Injection, 100 mcg
HCPCS Level II code J1626 denotes a 100 mcg injection of granisetron hydrochloride, an antiemetic commonly used in oncology care to prevent or treat chemotherapy-induced nausea and vomiting. Nationally, accurate coding for infused and injected oncology drugs matters for clinical documentation, payer coverage determinations, and cost management across outpatient infusion centers and hospital outpatient departments. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what J1626 represents clinically and operationally, plus benchmarking context and policy-relevant considerations. The publication covers standard billing practices for injectable oncology drugs, payer coverage patterns and variability, and factors that influence reimbursement such as site of service and drug unitization. The content also highlights common modifiers associated with injectable drug administration and notes where input data were not provided. This summary equips revenue cycle, clinical, and policy stakeholders with a clear understanding of the code’s purpose, typical use settings, and the payer landscape relevant to granisetron hydrochloride injection.
Billing Code Overview
HCPCS Level II code J1626 represents an injection of granisetron hydrochloride, with a unit defined as 100 mcg. This code is used to report administration of the antiemetic agent granisetron for prevention or treatment of nausea and vomiting associated with chemotherapy or other clinical indications.
Service Type: Injection / Drug Administration
Typical Site of Service: Outpatient infusion or clinic setting, including oncology infusion centers and hospital outpatient departments.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult receiving chemotherapy for solid tumor malignancy (for example, colorectal or ovarian cancer) who requires prophylaxis or treatment of chemotherapy-induced nausea and vomiting (CINV). The patient presents to an outpatient oncology infusion center or hospital outpatient department for scheduled intravenous chemotherapy. The healthcare team prepares and administers supportive medications including antiemetics. J1626 (granisetron hydrochloride injection, 100 mcg) is administered intravenously or via subcutaneous injection immediately before or during chemotherapy to prevent acute or delayed CINV. Documentation includes indication (chemotherapy regimen with emetogenic potential), route and dose of granisetron, time of administration, lot number, and consenting clinician. Typical workflow steps: medication order verification by oncology provider, pharmacy preparation and labeling, nurse verification of patient identity and allergies, administration with vital sign monitoring, and documentation of response and any adverse effects.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/unused | Use when a portion of a single-use vial of granisetron is discarded and payer requires reporting of wasted drug. |