Summary & Overview
HCPCS J9262: Injection, omacetaxine mepesuccinate, 0.01 mg
Headline: HCPCS Level II code J9262 designates omacetaxine mepesuccinate injection, a targeted antineoplastic agent used in oncology care. Lead: HCPCS Level II code J9262 covers administration of omacetaxine mepesuccinate measured in 0.01 mg units, relevant for billing of injectable chemotherapy in outpatient and hospital settings.
HCPCS Level II code J9262 represents the billed drug supply for omacetaxine mepesuccinate, an agent used in certain hematologic malignancies. Nationally, accurate capture of this code is important for chemotherapy drug reimbursement, inventory management, and quality reporting across oncology practices and hospital outpatient departments. The code is used where omacetaxine is administered as an injectable therapy, typically in infusion suites.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and the payer landscape. The publication summarizes available benchmarks, common billing modifiers and coding considerations, and relevant policy updates affecting drug administration codes.
This brief provides a focused reference for billing staff, revenue cycle managers, and clinical administrators seeking a national perspective on coding and billing for omacetaxine mepesuccinate injections using HCPCS Level II code J9262.
Billing Code Overview
HCPCS Level II code J9262 represents an injection of omacetaxine mepesuccinate with a billing unit of 0.01 mg. This code denotes administration of the antineoplastic agent omacetaxine mepesuccinate, typically used in oncology treatment regimens.
Service Type: Drug administration / Injectable chemotherapy
Typical Site of Service: Outpatient infusion center or hospital outpatient department
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with chronic myeloid leukemia (CML) or another hematologic malignancy who has failed or is intolerant to tyrosine kinase inhibitor therapy and requires treatment with omacetaxine mepesuccinate. The drug is supplied and billed per 0.01 mg unit (J9262). Care is delivered in an outpatient oncology infusion clinic, specialty infusion center, or hospital outpatient department. Workflow: patient evaluation by an oncologist (review diagnosis, prior therapies, labs), informed consent, venous access assessment (peripheral IV or implantable port), pre-medication and supportive orders as indicated, drug preparation by pharmacy under sterile conditions, administration by an infusion nurse with monitoring for cytopenias and injection-related reactions, documentation of dose and lot number, and follow-up hematology visits and laboratory monitoring (CBC with differential) to assess response and toxicity. Typical sites of service: outpatient infusion center, physician office-based infusion suite, or hospital outpatient department. Common patient scenario: a 62-year-old patient with CML resistant to second-line tyrosine kinase inhibitor therapy presenting for cycle-based subcutaneous or intravenous administration of omacetaxine, with baseline CBC showing neutropenia risk and an established plan for growth factor support or dose delay if required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — baseline billing |