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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9261-nelarabine-injection-50mg-chemotherapy
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    HCPCS J9261: Nelarabine Injection, 50 mg

    HCPCS Level II code J9261 denotes a billed unit for nelarabine injection, 50 mg, used as an antineoplastic chemotherapy agent administered intravenously; the service is a chemotherapy drug administration typically provided in hospital outpatient infusion centers or oncology clinics for treatment of hematologic malignancies.

    For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult or adolescent with relapsed or refractory T-cell acute lymphoblastic leukemia (T-ALL) or T-cell lymphoblastic lymphoma who is scheduled to receive systemic nelarabine chemotherapy. The patient presents to an outpatient oncology infusion center or an inpatient hematology/oncology unit for administration. Pre-infusion workflow includes verification of diagnosis and prior therapies, baseline neurologic assessment, review of prior laboratory results (complete blood count, metabolic panel), confirmation of venous access (peripheral IV or central venous catheter), medication order verification by pharmacy, and chemotherapy consent documentation. Nelarabine is prepared by pharmacy as a preservative-free injectable solution and dosed per body surface area; J9261 denotes each 50 mg unit of the drug for billing. During infusion, nursing monitors for infusion-related reactions, neurotoxicity signs, and cytopenia-related complications. Post-infusion care includes observation for acute adverse events, scheduling of subsequent cycles, documentation of drug lot and units administered, and coordination of supportive care (growth factor support, antiemetics, antimicrobial prophylaxis) as indicated. Typical sites of service are an outpatient hospital-based or freestanding infusion center, physician office infusion suite, or inpatient oncology ward depending on patient acuity and payer requirements.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipuncturePerformed pre-infusion for baseline labs (CBC, chemistries) required before nelarabine administration.
    36561Insertion of central venous catheter, non-tunneled (for chemotherapy)May be performed prior to nelarabine for patients needing reliable central access for repeated infusions.
    96365Intravenous infusion, therapeutic, prophylactic, or diagnostic; initial, up to 1 hourUsed to report the infusion administration service for the initial hour of nelarabine infusion when applicable to payer rules.
    96366Each additional hour (list separately in addition to code for primary infusion)Used to report additional infusion time beyond the first hour when nelarabine infusion extends longer than 1 hour.
    96413Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (up to 1 hour)Used in some workflows to bill for chemotherapy infusion services when protocols require multiple sequential infusions or separate administration codes per payer policy.
    96360Intravenous infusion for chemotherapy, up to 1 hour, single or initial substance/drugAlternative administration code used by some providers for billing a chemotherapy drug infusion session; selection depends on payer and protocol documentation.

    Related Modifiers

    8 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…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    207L00000X
    283Q00000X
    364S00000X
    363A00000X
    1835P1200X
    2084A0401X
    225XH1300X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    B20Human immunodeficiency virus [HIV] disease
    C83.90Non-follicular (diffuse) lymphoma, unspecified, unspecified site
    C83.99Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites
    C84.10Sezary disease, unspecified site
    C84.11Sezary disease, lymph nodes of head, face, and neck
    C85.90Non-Hodgkin lymphoma, unspecified, unspecified site
    C91.01Acute lymphoblastic leukemia, in remission
    C91.11Chronic lymphocytic leukemia of B-cell type in remission
    C91.31Prolymphocytic leukemia of B-cell type, in remission
    C91.41Hairy cell leukemia, in remission

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    Electric Tumor Treatment Field Therapy (for Tennessee Only)Colorado Rocky Mountain Health Plans2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    OmisirgeCigna2026-11-01
    Hematology - AdzynmaCigna2026-10-15
    Transcatheter Arterial Chemoembolization for Liver Tumorspremerabluecrossofwashington2026-10-01
    Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bonepremerabluecrossofwashington2026-10-01

    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-J9017-ARSENIC-TRIOXIDE-INJECTION-1MG

    HCPCS J9017: Arsenic Trioxide Injection, 1 mg

    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

    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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