Summary & Overview
HCPCS J9054: Bortezomib Injection, 0.1 mg
HCPCS Level II code J9054 denotes a 0.1 mg unit of bortezomib, a systemic injectable chemotherapy agent used in oncology. Nationwide, accurate coding of biologic and antineoplastic agents like bortezomib is critical for clinical documentation, treatment planning, and payer processing due to high-cost drug handling and site-of-service implications. This code is used when billing discrete units of bortezomib administered by clinicians in infusion settings. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of clinical context for bortezomib administration, the common sites of service associated with this HCPCS Level II code, and which payers are typically involved in coverage and reimbursement. The publication provides benchmarks and coding guidance context where available, highlights common modifier usage patterns and payer interactions (modifier names listed separately), and outlines policy considerations relevant to drug billing and infusion services. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code J9054 describes an injection of bortezomib (boruzu), 0.1 mg. This code represents a parenteral antineoplastic drug administered for systemic cancer therapy. The service type is injectable chemotherapy/biologic drug administration, typically delivered in oncology infusion centers, hospital outpatient departments, or clinic-based infusion suites.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult diagnosed with multiple myeloma or mantle cell lymphoma receiving systemic chemotherapy with the proteasome inhibitor bortezomib. The patient presents to an oncology infusion clinic or hospital outpatient infusion center for administration of J9054 (injection, bortezomib, 0.1 mg). Prior to treatment the oncology nurse verifies the chemotherapy orders, reviews recent labs (complete blood count, liver function tests), checks for peripheral neuropathy symptoms, confirms venous access (PICC, port, or peripheral IV), and performs a time-out. Bortezomib is prepared by the pharmacy under sterile conditions and delivered with appropriate labeling; the dose is calculated based on body surface area or fixed dosing per protocol and converted to vial units billed using J9054 per 0.1 mg. The nurse administers subcutaneous or intravenous bortezomib per the prescribing regimen, monitors vital signs and infusion-site reactions, documents the lot number and units administered, and provides patient education on adverse effects and when to seek care. Typical sites of service include hospital outpatient departments, physician office infusion centers, and ambulatory oncology infusion clinics. Common patient scenarios include induction therapy, relapse treatment, or maintenance regimens where bortezomib is part of a multi-agent chemotherapy protocol.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |