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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9298-nivolumab-relatlimab-injection
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    HCPCS Level II J9298: Nivolumab and Relatlimab Injection, 3 mg/1 mg

    HCPCS Level II code J9298 describes the injectable combination product nivolumab and relatlimab-rmbw, 3 mg/1 mg supplied for infusion; the code represents a single unit of the specified drug combination typically used for oncology infusion therapy and is billed for intravenous administration in hospital outpatient infusion centers, oncology clinics, or other outpatient infusion settings.

    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 63-year-old patient with unresectable or metastatic melanoma presents to the oncology infusion suite for administration of combination immunotherapy. The clinician has ordered J9298 (injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg) as part of first-line systemic therapy. The patient is registered at the infusion center, vital signs are obtained, chemotherapy consent and allergy review are confirmed, and medication reconciliation is completed. A certified oncology pharmacist or registered nurse verifies the prescribed dose, inspects the infusion bag, and programs the infusion pump. The dose is administered intravenously per protocol over the recommended infusion time while the patient is monitored for infusion-related reactions and immune-mediated adverse events. Post-infusion, the patient is observed for a defined interval, provided discharge instructions about symptoms of immune-related toxicity (such as pneumonitis, colitis, hepatitis, endocrinopathies), and scheduled for follow-up visits and laboratory monitoring (including liver function tests, thyroid function, and complete blood count). Billing for the drug uses the HCPCS Level II code J9298 and may include appropriate modifiers to reflect circumstances such as administration location, partial administration, or shipment/handling situations. The typical site of service is an outpatient oncology clinic or hospital outpatient infusion center. The typical patient scenario involves adults with advanced melanoma or other approved indications receiving combination checkpoint inhibitor therapy under oncologist supervision.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourUsed for the initial infusion time period for administration of J9298 when billed for infusion service separate from drug acquisition.
    96366Intravenous infusion, each additional hour (List separately in addition to code for primary infusion)Used when infusion extends beyond the initial hour and additional infusion time is billed.
    96413Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drugApplicable when facility or payer requires chemotherapy administration CPT coding for oncologic drugs.
    96415Chemotherapy administration, each additional hour (List separately in addition to code for primary infusion)Used for extended administration time of infusion therapies.
    96360Intravenous infusion, hydration; initial, 31 minutes to 1 hourUsed when intravenous hydration is provided concomitantly during infusion.
    95970Electronic analysis of implanted neurostimulator pulse generator systemData not applicable to this therapy but included only if implantable device monitoring is performed concurrently (not typical).

    Note: If payer or facility bundles drug acquisition into the visit, CPT administration codes may not be separately payable. Billing for J9298 typically focuses on the HCPCS drug code plus applicable infusion administration CPTs as permitted by the payer.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    163W00000X
    363LA2200X
    363LP0200X
    163WN0800X
    251X00000X
    103TE1100X
    2086S0129X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C22.0Liver cell carcinoma
    C25.9Malignant neoplasm of pancreas, unspecified
    C34.11Malignant neoplasm of upper lobe, right bronchus or lung
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C34.91Malignant neoplasm of unspecified part of right bronchus or lung
    C43.9Malignant melanoma of skin, unspecified
    C45.9Mesothelioma, unspecified
    C50.911Malignant neoplasm of unspecified site of right female breast

    Showing 1–10 of 27

    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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