Summary & Overview
HCPCS J9130: Dacarbazine, 100 mg Intravenous Chemotherapy
HCPCS Level II code J9130 denotes dacarbazine, 100 mg, a cytotoxic chemotherapy agent used in multiple oncology indications. Nationally, chemotherapy drug codes are central to oncology billing, utilization tracking, and payer coverage policies because they carry significant cost implications for payers and patients and are tied to site-of-service and drug administration protocols. Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of what J9130 represents clinically and operationally, followed by benchmark and coverage context where available. The publication outlines typical billing practices for a unit-based oncology drug code, common clinical settings for administration, and the types of benchmarks and policy updates that affect chemotherapy drug reimbursement and utilization. Where specific payer policies differ, the discussion summarizes general themes in coverage and site-of-service considerations. Data not available in the input will be noted explicitly where applicable.
Billing Code Overview
HCPCS Level II code J9130 represents Dacarbazine, 100 mg, an antineoplastic (chemotherapy) agent supplied and billed per 100 mg unit. The service type is administration of an oncologic chemotherapy drug. The typical site of service for this medication is an outpatient infusion center, hospital outpatient department, or oncology clinic where intravenous chemotherapy is administered.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with metastatic melanoma or Hodgkin lymphoma receiving systemic chemotherapy with dacarbazine. The patient presents to an outpatient oncology infusion center for scheduled intravenous chemotherapy. Relevant pre-infusion steps include verification of diagnosis, review of recent labs (complete blood count, hepatic and renal function), assessment for active infections or contraindications, informed consent, and confirmation of the ordered dacarbazine dose in milligrams. Pharmacy prepares J9130 (dacarbazine, 100 mg) as a sterile compounded intravenous medication, labeled with total milligrams dispensed. The infusion nurse confirms patient identity, reviews allergies, establishes venous access (peripheral IV or port), administers antiemetics per protocol, and infuses dacarbazine over the institution’s recommended rate while monitoring for acute infusion reactions. Post-infusion, the patient is observed briefly for delayed hypersensitivity, provided with discharge instructions, and scheduled for follow-up labs and subsequent cycles. Typical sites of service are outpatient hospital infusion centers, physician office-based infusion suites, and ambulatory infusion centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|