Summary & Overview
HCPCS Level II J9174: Docetaxel (Beizray) Injection, 1 mg
HCPCS Level II code J9174 designates injection dosing for docetaxel (Beizray) billed per 1 mg, used in oncology infusion settings. This code matters nationally because it standardizes reporting and reimbursement for a commonly administered cytotoxic chemotherapy agent, affecting provider billing, pharmacy acquisition planning, and payer coverage determinations for cancer care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the code is used clinically and operationally, benchmarks for reimbursement and utilization where available, common billing modifiers and coding considerations, and implications for payer coverage policies and prior authorization practices. The publication also summarizes service-line and site-of-service implications for hospital outpatient departments and physician office infusion centers.
The content is designed to inform billing staff, oncology clinic administrators, pharmacy directors, and payer policy analysts about the code’s clinical role, typical billing scenarios, and topics that may influence coding accuracy and claims outcomes. Data not available in the input will be noted where relevant.
Billing Code Overview
HCPCS Level II code J9174 represents the injectable oncology medication docetaxel (beizray) dosed per 1 mg. The service type is medication administration (intravenous chemotherapy infusion and injection). The typical site of service is hospital outpatient infusion center or physician office infusion clinic.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a solid tumor such as metastatic breast, non–small cell lung, or prostate cancer receiving systemic chemotherapy in an outpatient infusion center. The medication administered is J9174 (docetaxel), billed per milligram. The patient arrives for an established chemotherapy visit for intravenous infusion; pre‑visit nursing assessment includes vital signs, laboratory review (especially neutrophil count and liver function tests), and confirmation of indication and consent. A chemotherapy-certified registered nurse prepares and administers J9174 under an oncologist’s order, using standard premedication (e.g., corticosteroid and antihistamine) to reduce hypersensitivity and fluid retention. The infusion is delivered via peripheral IV or implanted venous access device (port or PICC), with monitoring for infusion reactions. Post‑infusion documentation includes dose (mg), lot/brand if required, infusion start/stop times, patient tolerance, and disposal of any wasted drug — documenting wastage when JW (drug discarded) modifier applies. Billing is per milligram for J9174, with appropriate ICD-10 diagnosis linkage, and may include procedure or infusion CPT codes for intravenous infusion services and port access as part of the visit workflow.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|