Summary & Overview
HCPCS Level II J2797: Injection, rolapitant 0.5 mg
HCPCS Level II code J2797 denotes the injection formulation of rolapitant, 0.5 mg, an antiemetic used to prevent chemotherapy-induced nausea and vomiting. Nationally, accurate coding for oncology supportive medications like rolapitant affects care coordination, prior authorization workflows, and pharmacy and infusion billing practices. This code is used across outpatient infusion centers, oncology clinics, and ambulatory care settings where parenteral antiemetic therapy is 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 what J2797 represents clinically and operationally, plus the payer landscape addressed. The publication summarizes where J2797 fits in the service line for outpatient oncology medication administration, common billing modifiers that may be encountered, and typical sites of service. It also outlines the types of benchmarks and policy considerations usually relevant for injectable oncology supportive agents: utilization tracking, coverage and prior authorization trends, and billing compliance considerations. Where specific inputs were not provided, the text notes that data are not available in the input. The material is intended for billing managers, revenue cycle leaders, oncology clinic administrators, and policy analysts seeking a focused reference on HCPCS Level II code J2797.
Billing Code Overview
HCPCS Level II code J2797 represents an injection of rolapitant, 0.5 mg. This billing code describes a single-dose injectable administration of rolapitant, an antiemetic agent used in the prevention of chemotherapy-induced nausea and vomiting. The service type is medication administration by injection. The typical site of service is an outpatient infusion center, oncology clinic, or other ambulatory care setting where parenteral chemotherapy support medications are given.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient receiving moderately to highly emetogenic chemotherapy who requires prophylaxis against delayed chemotherapy-induced nausea and vomiting (CINV). Rolapitant is administered as an antiemetic NK1 receptor antagonist to prevent delayed-phase CINV in combination with a 5-HT3 antagonist and dexamethasone. The clinical workflow: chemotherapy prescribing and consent; order entry for J2797 with the exact dose calculated (0.5 mg units billed per 0.5 mg increment); nursing verification of prior antiemetic regimen and allergies; preparation of the injectable formulation in a clinic infusion pharmacy or outpatient infusion center; documentation of administration time, lot number, and site of service; observation for immediate adverse reactions for 30–60 minutes; and integration of the administration record into the oncology treatment plan and the electronic medical record for subsequent chemotherapy cycles and prior authorization/billing. Typical site of service is an outpatient infusion center or hospital outpatient department where intravenous or injectable supportive care medications are administered.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard use when no modifier applies to the service |