Summary & Overview
HCPCS Level II J1627: Granisetron Extended-Release Injection, 0.1 mg
HCPCS Level II code J1627 denotes an extended-release injectable formulation of granisetron, 0.1 mg, used as an antiemetic for prevention of chemotherapy-related nausea and vomiting. As an administered medication, this code identifies the drug product and supports billing for facility and professional claims where an extended-release antiemetic is provided during infusion or outpatient oncology encounters. Nationally, clear coding for long-acting antiemetic injections matters for accurate drug utilization tracking, reimbursement consistency, and care coordination in oncology services.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical sites of service, common modifiers and coding considerations, and the clinical context for granisetron extended-release injections. The publication summarizes payer coverage patterns and benchmark considerations where available, highlights common billing modifiers used with HCPCS Level II drug codes, and outlines operational points relevant to infusion centers and outpatient oncology clinics.
This summary is intended for billing managers, practice administrators, and policy analysts seeking a concise reference for HCPCS Level II code J1627, including clinical purpose, service setting, and payer landscape. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code J1627 describes an injection of granisetron, extended-release, 0.1 mg. This code covers a single-dose, extended-release injectable formulation of granisetron, an antiemetic agent used to prevent nausea and vomiting associated with chemotherapy or other emetogenic treatments.
Service Type: Medication administration (injectable), extended-release antiemetic
Typical Site of Service: Infusion center, outpatient oncology clinic, hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient scheduled to receive a single-dose intramuscular or subcutaneous extended-release antiemetic prior to a moderately or highly emetogenic chemotherapy regimen. The patient presents to an outpatient oncology infusion clinic or ambulatory surgical center for pre-chemotherapy evaluation. The oncology nurse verifies chemotherapy orders, reviews prior antiemetic response and potential drug interactions, documents allergies, obtains baseline vitals, and administers J1627 (granisetron, extended-release, 0.1 mg) as a single injection at least 30 minutes before chemotherapy start per institutional protocol. Observation for immediate adverse reaction occurs in the infusion chair for 15–30 minutes. The extended-release formulation is intended to provide prolonged 5-HT3 receptor antagonism to prevent acute and delayed chemotherapy-induced nausea and vomiting (CINV), reducing the need for repeat dosing during the chemotherapy cycle. Typical sites of service include outpatient infusion centers, physician offices with infusion capability, same-day surgery or ambulatory infusion suites, and hospital outpatient departments when administered on an outpatient basis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no special modifier applies to the service |
11 | Primary procedure | Use when this injection is the primary procedure for the encounter