Summary & Overview
HCPCS Level II J9315: Injection, romidepsin, 1 mg
HCPCS Level II code J9315 denotes a unit-based billing code for romidepsin injection (1 mg), an intravenous antineoplastic agent used in oncology care. Nationally, this code matters because it standardizes reporting for administration of a high-cost, specialty chemotherapy drug across clinical settings, impacting claims processing, reimbursement workflows, and utilization monitoring.
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 clinical context for romidepsin administration, typical sites of service where J9315 is billed, and what to expect in payer coverage patterns. The publication outlines common billing modifiers associated with chemotherapy administration and points to areas where policy updates or payer-specific billing requirements commonly arise.
This summary equips clinicians, practice managers, and billing staff with an understanding of how J9315 is used on service lines for infusion encounters, the importance of accurate unit reporting for drug dosing, and the types of benchmarks and policy considerations that affect nationwide claims and reimbursement processes.
Billing Code Overview
HCPCS Level II code J9315 represents the injection of romidepsin, 1 mg. This code is used to report administration of the antineoplastic agent romidepsin in a unit-based dosing format.
Service Type: Medication administration / Injectable chemotherapy
Typical Site of Service: Hospital outpatient department, ambulatory infusion center, or physician office infusion suite
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with peripheral T-cell lymphoma or cutaneous T-cell lymphoma who is scheduled to receive intravenous romidepsin as part of an oncology treatment regimen. The patient presents to an outpatient infusion center or hospital oncology infusion unit for administration of J9315 (romidepsin) dosed per body surface area or manufacturer guidance. Prior to infusion, an oncologist documents indication, baseline labs (CBC, CMP, magnesium, potassium), recent ECG for QT interval assessment, and reviews concomitant medications for QT-prolonging interactions. A chemotherapy-certified registered nurse performs venous access verification (peripheral IV or implanted port), prepares the drug per USP <797>/<800> compounding standards or pharmacy protocol, and administers romidepsin intravenously over the recommended infusion time with appropriate monitoring for infusion reactions and cardiac events. Post-infusion, the patient is observed for adverse events, supportive medications (antiemetics, electrolyte replacement) are given as needed, and documentation includes drug name, NDC or HCPCS J9315, dose in mg, lot number, infusion start/stop times, and any applicable modifier(s). Billing occurs from the infusion facility or hospital outpatient group, using J9315 billed per mg units with applicable CPT codes for infusion administration and evaluation services appended as appropriate.
Coding Specifications
| Modifier | Description | When to Use |
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