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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9017-arsenic-trioxide-injection-1mg
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    HCPCS J9017: Arsenic Trioxide Injection, 1 mg

    HCPCS Level II code J9017 describes Injection, arsenic trioxide, 1 mg, a parenteral chemotherapy agent usually administered as an intravenous infusion for oncology indications; the service is a medication administration involving pharmacy-dispensed antineoplastic therapy typically delivered in an outpatient infusion center or hospital outpatient department.

    For related coverage guidance, see recent payer policy updates: Hematology - Adzynma, Tumor Treating Fields for Pancreatic Cancer, Axicabtagene ciloleucel (Yescarta®) coverage.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult diagnosed with relapsed or refractory acute promyelocytic leukemia (APL) presenting to an outpatient oncology infusion center or inpatient hematology/oncology unit for administration of J9017 (arsenic trioxide). The clinical workflow begins with hematology/oncology evaluation, review of baseline labs (complete blood count, comprehensive metabolic panel including electrolytes, magnesium, calcium, and hepatic function), and baseline electrocardiogram (ECG) to assess QTc. Vascular access is confirmed (peripheral IV or central venous catheter) and premail medications (antiemetics, electrolyte repletion) are administered as needed. The pharmacy compounds arsenic trioxide per protocol and documents lot and dose; the infusion nurse verifies patient identity, allergy status, and consent. The drug is infused over the institution-specified time with continuous monitoring for cardiac arrhythmia, fluid shifts, and infusion reactions; serial laboratory monitoring and ECGs are obtained during induction and consolidation phases per oncology protocol. Dose adjustments or treatment holds are documented if severe toxicity, QTc prolongation, or organ dysfunction occurs. Billing uses J9017 per milligram dispensed with appropriate site-of-service designation for outpatient infusion centers, hospital outpatient departments, or inpatient care depending on the treatment setting.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipuncturePerformed for baseline and serial laboratory monitoring before and during arsenic trioxide therapy.
    36000Introduction of needle or intracatheter, veinUsed when peripheral IV is placed specifically for administration if billed separately.
    36561Therapeutic apheresis, blood components, and plasmapheresisOccasionally used in management of differentiation syndrome or other complications requiring apheresis — infrequently related.
    36478Injection, intrathecal, chemotherapy agentNot typically used for arsenic trioxide (systemic IV), included only for completeness when intrathecal administration of other agents is required concurrently.
    96365Intravenous infusion, for chemotherapy, up to 1 hourUsed to report the chemotherapy infusion administration time for outpatient billing when infusion duration applies.
    96366Each additional hour (chemotherapy infusion)Used when the infusion duration exceeds the base unit and additional hourly time requires billing.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    364S00000X
    208000000X
    363L00000X
    363A00000X
    164W00000X
    3104A0630X
    363LG0600X

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Hematology - AdzynmaCigna2026-10-15
    Tumor Treating Fields for Pancreatic Cancerselect_health2026-10-01
    Axicabtagene ciloleucel (Yescarta®) coverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Kansas Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Idaho Only)UnitedHealthcare2026-10-01
    Brexucabtagene autoleucel (Tecartus) CoverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Factor VIII ProductsCigna2026-09-15

    Related Codes

    HCPCS-J9000-DOXORUBICIN-10MG-INJECTION

    HCPCS J9000: Doxorubicin Hydrochloride Injection, 10 mg

    HCPCS-J9003-LEUPROLIDE-INJECTABLE-CAMCEVI-1MG

    HCPCS Level II J9003: Leuprolide injectable (camcevi etm), 1 mg

    HCPCS-J9010-ALEMTUZUMAB-INJECTION-10MG

    HCPCS Level II J9010: Injection, alemtuzumab, 10 mg

    HCPCS-J9011-DATOPOTAMAB-DERUXTECAN-INJECTION-1MG

    HCPCS J9011: Datopotamab Deruxtecan Injection, 1 mg

    HCPCS-J9015-ALDESLEUKIN-INJECTION-SINGLE-USE-VIAL

    HCPCS Level II J9015: Aldesleukin Injection, Single-Use Vial

    HCPCS-J9019-ASPARAGINASE-ERWINAZE-INJECTION-1000-IU

    HCPCS Level II J9019: Asparaginase (Erwinaze) Injection, 1,000 IU

    HCPCS-J9020-ASPARAGINASE-INJECTION-10000-UNITS

    HCPCS J9020: Asparaginase Injection, 10,000 Units

    HCPCS-J9021-ASPARAGINASE-RYLAZE-INJECTION-0-1-MG

    HCPCS Level II J9021: Injection, asparaginase (Rylaze), 0.1 mg

    HCPCS-J9022-ATEZOLIZUMAB-INJECTION-10MG

    HCPCS J9022: Injection, atezolizumab 10 mg

    HCPCS-J9023-AVELUMAB-10MG-INJECTION

    HCPCS J9023: Avelumab Injection, 10 mg

    Showing 1–10 of 227

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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