Summary & Overview
HCPCS J9273: Injection, tisotumab vedotin-tftv, 1 mg
HCPCS Level II code J9273 designates the injection of tisotumab vedotin-tftv at a unit dose of 1 mg, a targeted oncology therapeutic used in specialty cancer care. Nationally, accurate coding for this medication is important for consistent billing, benefit administration, and coverage decisions for high-cost infused or injected cancer therapies. The analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what J9273 represents clinically and operationally, typical sites of service, and which major payers are covered in the review. The publication provides benchmarks and payment context where available, summarizes recent policy and coverage considerations relevant to biologic and antibody–drug conjugate therapeutics, and outlines coding and service-line implications for outpatient oncology infusion centers. It also highlights common modifiers used with injectable drugs and notes when input data elements are not provided. Data not available in the input will be identified as such.
Billing Code Overview
HCPCS Level II code J9273 represents an injection of tisotumab vedotin-tftv, 1 mg. This billing code describes administration of the specified oncology biologic by parenteral injection. The service type is an injectable antineoplastic/targeted therapy, and the typical site of service is an outpatient infusion or oncology clinic where intravenous or subcutaneous cancer therapies are administered.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with recurrent or metastatic cervical cancer or another FDA-approved solid tumor indication for tisotumab vedotin-tftv who presents to an outpatient oncology infusion center for administration. The oncology team confirms recent clinic visit documentation supporting treatment intent, reviews baseline labs (complete blood count, liver function tests), and assesses performance status and adverse effects from prior therapy. The drug vial is reconstituted and dose calculated by weight or body surface area per manufacturer guidance; billing is reported in milligrams using HCPCS. The patient is placed in a reclined infusion chair; intravenous access is obtained via peripheral IV or implanted port. Premedication and ocular prophylaxis per protocol are administered as indicated. Tisotumab vedotin-tftv is administered by IV infusion over the required duration under direct supervision of an oncology nurse and physician. Post-infusion monitoring includes vital signs and assessment for infusion-related reactions, ocular toxicity, neuropathy, and bleeding. Documentation includes drug name J9273 with total milligrams administered, lot number, expiration, route, and site, as well as all relevant clinical monitoring and any modifier(s) applicable to billing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered | Use when partial vial drug is discarded and payer requires reporting of wasted amount. |