Summary & Overview
HCPCS J9330: Injection, Temsirolimus, 1 mg
HCPCS Level II code J9330 designates the injection of temsirolimus, 1 mg, an intravenous antineoplastic agent used in oncology care. Nationally, this code is used to bill for the drug product itself when temsirolimus is dispensed and administered as part of systemic cancer therapy. Accurate coding of J9330 affects drug reimbursement, clinical documentation, and claims processing across outpatient infusion settings.
This analysis covers common national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report outlines payer coverage patterns, reimbursement benchmarks, and common billing practices affecting claims for temsirolimus. Readers will find a concise clinical context for J9330, typical sites of service, and a summary of the payment environment. The publication highlights benchmarks and policy-relevant considerations without providing clinical guidance. When specific payer policy details are unavailable, the report notes that data are not provided in the input. The content is intended for billing managers, revenue cycle professionals, and policy analysts seeking a national overview of coding and payment considerations for HCPCS Level II code J9330.
Billing Code Overview
HCPCS Level II code J9330 describes the injection of temsirolimus, 1 mg. This code represents a systemic oncology medication administered by intravenous infusion. The service type is a drug administration for chemotherapy/antineoplastic therapy. The typical site of service for this administration is an outpatient infusion center, hospital outpatient department, or physician office where intravenous chemotherapy is provided.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with advanced renal cell carcinoma or other malignant solid tumor for which systemic therapy with temsirolimus is indicated. The patient presents to an outpatient oncology infusion clinic for intravenous administration of J9330 (temsirolimus, per 1 mg). Prior to infusion, an oncology nurse verifies diagnosis, recent labs (CBC, CMP), weight-based dosing, premedication status (e.g., antihistamine if prior hypersensitivity), and vascular access. The pharmacist compounds the required dose from the vial(s) using aseptic technique. The infusion is administered via peripheral IV or central venous catheter over the institution-specific infusion time per prescribing information. Nursing monitors vital signs and for infusion reactions during and after administration. Documentation includes the drug name and NDC, units administered in milligrams, lot number, expiration, route, site of service, applicable modifier(s), and the associated ICD-10 diagnosis code(s). Billing uses HCPCS Level II code J9330 with an appropriate modifier for clinical circumstances and facility billing rules.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no other modifier applies and service is billed routinely |