Summary & Overview
HCPCS J9282: Mitomycin Intravesical Instillation, 1 mg
HCPCS Level II code J9282 identifies a 1 mg unit of mitomycin delivered by intravesical instillation. The code is used to bill for localized chemotherapy administered directly into the bladder, a common approach in managing non‑muscle invasive bladder cancer to reduce recurrence risk. Nationally, accurate coding of intravesical agents affects outpatient oncology and urology reimbursement, utilization tracking, and medication safety programs.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for billing and utilization, an overview of payer coverage patterns, and concise clinical context for intravesical mitomycin. The publication summarizes common service settings, billing considerations relevant to outpatient infusion and urology clinic workflows, and policy updates that influence coverage and coding for instilled chemotherapeutic agents.
This summary provides clinicians, coders, and revenue cycle professionals with the essential context for HCPCS Level II code J9282, enabling informed coding and administrative decisions at a national level. Data not available in the input are noted where appropriate.
Billing Code Overview
HCPCS Level II code J9282 represents Mitomycin, intravesical instillation, 1 mg. This code describes the administration of mitomycin directly into the bladder (intravesical) for local treatment, typically used in the management of non-muscle invasive bladder cancer and other bladder pathologies responsive to intravesical chemotherapy.
Service Type: Intravesical chemotherapy instillation
Typical Site of Service: Outpatient infusion clinic, ambulatory surgery center, or urology clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with non–muscle-invasive bladder cancer (NMIBC) such as carcinoma in situ or papillary Ta/T1 lesions following transurethral resection of bladder tumor (TURBT). The patient presents for intravesical chemotherapy with mitomycin C after surgical resection to reduce recurrence risk. The clinical workflow: patient arrival to an outpatient urology clinic or ambulatory surgery center; pre-procedure verification of identity, allergies, and anticoagulation status; bladder catheterization or use of an existing urethral catheter; instillation of J9282 (Mitomycin, intravesical instillation, 1 mg) prepared by pharmacy to prescribed dose and concentration; dwell time typically 1–2 hours with the patient repositioned periodically; catheter removal and post-procedure observation for urinary symptoms, dysuria, hematuria, or allergic reaction; discharge with return precautions and scheduled follow-up cystoscopy for surveillance. Typical site of service is an outpatient urology clinic, ambulatory surgical center, or hospital outpatient department. Typical patient scenario: a 68-year-old male, 2 weeks post-TURBT for high-grade Ta tumor, scheduled for intravesical mitomycin C instillation to reduce tumor recurrence risk; no active infection and normal renal function; receives J9282 per physician order with nursing administration and documented dwell time.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |