HCPCS J9047: Injection, Carfilzomib, 1 mg

HCPCS Level II code J9047 denotes an injection of carfilzomib, dosed at 1 mg, used in oncology infusion settings. The code is important nationally as it captures administration of a targeted proteasome inhibitor commonly used in multiple myeloma treatment regimens and informs drug utilization, billing, and coverage decisions across payer systems. Accurate coding of J9047 affects reimbursement for drug acquisition and infusion services and supports tracking of high-cost oncology therapies.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of payer coverage patterns, standard billing practices for drug injection codes, and a clinical context for carfilzomib administration. The publication outlines benchmarks for unit dosing claims, common modifier use (listed separately), and implications for billing workflows in outpatient infusion centers and hospital outpatient departments.

This summary provides national-level guidance on the role of HCPCS Level II code J9047 in claims processing, the types of service environments where the code is typically used, and what to expect when reconciling drug units to administered doses. Data not available in the input is noted where applicable.

Billing Code Overview

HCPCS Level II code J9047 represents an injection of carfilzomib, dosed per 1 mg. This service is a pharmacologic cancer therapy administration involving the provision of the chemotherapeutic agent carfilzomib for intravenous use.

Service type: Drug administration / oncology infusion

Typical site of service: Outpatient infusion center or hospital outpatient department

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical Context

A typical patient receiving J9047 (carfilzomib injection, per 1 mg) is an adult with relapsed or refractory multiple myeloma who presents to an outpatient oncology infusion center or hospital outpatient department for scheduled chemotherapy. The clinical workflow begins with verification of diagnosis, review of recent labs (CBC, chemistry panel, baseline cardiac assessment), and calculation of the ordered carfilzomib dose based on body surface area or fixed dosing per the oncologist's regimen. Pharmacy compounds the vialized product and labels the exact mg dose. The patient is triaged by nursing, intravenous access is confirmed or placed, premedications (antiemetic, dexamethasone per protocol) are administered as ordered, and an infusion pump is programmed for the prescribed infusion rate and total dose. Nursing monitors vital signs and infusion tolerance, documents medication administration in the electronic health record, and communicates any adverse reactions for clinician management. After infusion completion, the patient is observed per protocol for infusion-related reactions and discharged with follow-up instructions and scheduling for the next cycle.

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug or biological quantity discarded	Use when part of the single-use vial is discarded after administration and payer requires reporting of discarded amount.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Medical Oncology	Primary specialty ordering and supervising systemic anti-cancer therapy including carfilzomib.
`2084P0800X`	Hematology	Hematologists manage multiple myeloma diagnosis and direct proteasome inhibitor therapy.
`163WK0400X`	Infusion Therapy	Nurses and providers specializing in administration of parenteral chemotherapy and infusion monitoring.
`363L00000X`	Oncology Nursing	Registered nurses certified in oncology who perform infusion administration and patient teaching.
`207L00000X`	Internal Medicine	Hospitalist or general internist involved when inpatient management of complications is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C90.00`	Multiple myeloma not having achieved remission	A primary indication for carfilzomib in relapsed/refractory multiple myeloma.
`C90.01`	Multiple myeloma in remission	Used when documenting maintenance or follow-up therapy contexts.
`C90.02`	Multiple myeloma in relapse	Common scenario where carfilzomib is administered for disease relapse.
`D47.2`	Monoclonal gammopathy of undetermined significance (MGUS)	May be listed for patients with plasma cell disorders under surveillance or evolving disease.
`I50.9`	Heart failure, unspecified	Important comorbidity to document because carfilzomib has potential cardiac adverse effects requiring monitoring.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96413`	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary infusion)	Used when carfilzomib infusion requires extended infusion time beyond the initial hour and billing for each additional hour is needed.
`96417`	Chemotherapy administration, injection, subcutaneous or intramuscular; each additional sequential infusion (List separately in addition to primary)	May be used for additional sequential infusions or injections administered during the same visit when applicable.
`96401`	Chemotherapy administration, intravenous infusion coding for initial hour of anti-neoplastic agent	Used to report the initial infusion administration service for carfilzomib when billed as a chemotherapy infusion visit.
`36415`	Collection of venous blood by venipuncture	Performed for baseline and monitoring labs before or during chemotherapy administration.
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Used when baseline or monitoring cardiac assessments (ECG) are performed due to carfilzomib's potential cardiotoxicity.

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Summary & Overview