Summary & Overview
HCPCS J1932: Lanreotide (cipla) Injection, 1 mg
HCPCS Level II code J1932 denotes injection of lanreotide (cipla), 1 mg, a physician-administered somatostatin analogue used in certain endocrine and oncologic conditions. Nationally, accurate coding for injectable specialty medications like lanreotide affects claim processing, site-of-service reporting, and drug utilization oversight. This code is relevant to hospital outpatient departments, infusion centers, and physician offices where the medication is prepared and administered.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for lanreotide administration, typical sites of service, and the billing considerations tied to a unit-based HCPCS Level II drug code. The publication summarizes benchmarks and coverage patterns where available, highlights common modifier usage for administration and billing complexity, and outlines policy and coding updates that may influence reimbursement pathways.
This resource is intended to provide clinicians, billers, and revenue cycle professionals with a national-level reference for coding and administrative classification of J1932, helping ensure consistent reporting across payers and care settings. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code J1932 describes an injection of lanreotide (cipla), with each unit equal to 1 mg. This code represents a medication administration service for a long-acting somatostatin analogue used in management of conditions where lanreotide is indicated.
Service type: Pharmacologic injection / Physician-administered drug
Typical site of service: Outpatient infusion or injection clinic, hospital outpatient department, or physician office
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A patient with a neuroendocrine tumor or acromegaly receives a physician-administered somatostatin analogue, formulated as lanreotide 1 mg for injection (J1932). Typical setting is an outpatient oncology, endocrinology, or infusion clinic staffed by physicians, nurse practitioners, registered nurses, and medical assistants. The patient arrives for a scheduled intramuscular or deep subcutaneous injection after review of prior imaging, laboratory results (including glucose and gallbladder monitoring when indicated), and verification of prior authorization and medication dosing. The clinical workflow includes medication reconciliation, verification of J1932 dose and lot number, informed consent and allergy check, preparation of the syringe or prefilled syringe per manufacturer instructions, administration using aseptic technique, observation for immediate adverse reactions for 15–30 minutes, documentation of injection site, lot number, dose, and any concurrent medications, and billing the appropriate HCPCS code J1932 with applicable modifier(s). Typical patient scenarios include maintenance therapy for metastatic neuroendocrine tumors to control hormone-related symptoms or for biochemical control in acromegaly after surgical or medical evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW |