Summary & Overview
HCPCS J9350: Injection, mosunetuzumab-axgb, 1 mg
HCPCS Level II code J9350 denotes the injectable oncology agent mosunetuzumab-axgb, billed per 1 mg unit. As an HCPCS Level II drug code, J9350 is used on medical claims to capture the cost of the biologic when administered in outpatient infusion settings. This code matters nationally because high-cost oncologic biologics are a major driver of outpatient drug spending and influence coverage policy, prior authorization practices, and site-of-care decisions across public and commercial payers.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical and billing context for J9350, including where the drug is typically administered and how it is reported on claims. The publication also summarizes what readers can expect in accompanying sections: national reimbursement benchmarks, payer coverage patterns and policy features, and relevant clinical context for mosunetuzumab-axgb use.
Data not available in the input includes specific reimbursement amounts, associated ICD-10 diagnoses, and payer-specific policy language. The remaining sections provide benchmarks, payer policy summaries, and coding considerations for facilities and clinicians billing HCPCS Level II code J9350.
Billing Code Overview
HCPCS Level II code J9350 represents the injection formulation mosunetuzumab-axgb, billed per 1 mg unit. This code is used for administration of the drug product when billed as a drug supply item rather than a bundled procedure.
Service Type: Pharmaceutical injection (antineoplastic/immunotherapy)
Typical Site of Service: Outpatient infusion center or hospital outpatient department, where parenteral oncology therapies are administered.
Clinical & Coding Specifications
Clinical Context
A 67-year-old patient with relapsed or refractory follicular lymphoma presents to an outpatient oncology infusion center for targeted immunotherapy with mosunetuzumab-axgb. The patient has undergone prior lines of systemic therapy and is evaluated by the hematologist-oncologist for eligibility, including review of recent labs (CBC, CMP), imaging, and performance status. Mosunetuzumab-axgb is administered as an intravenous infusion in a controlled infusion suite or hospital outpatient department with staff experienced in management of cytokine release syndrome (CRS) and immune-related adverse events. Pre-infusion steps include verification of identity, informed consent specific to therapy, medication preparation by pharmacy under sterile conditions, and pre-medication per institutional protocols (for example acetaminophen, antihistamine ± corticosteroid). During infusion, nursing monitors vital signs frequently and observes for signs of CRS, neurologic changes, infusion reactions, or hypersensitivity. Post-infusion observation and follow-up visits include toxicity assessment, lab monitoring, and scheduling of subsequent doses per the prescribed dosing schedule. Billing for the drug is reported using J9350 per milligram dispensed, and appropriate procedural and facility modifiers are appended as needed for payer reporting and reimbursement adjudication.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered to any patient |