Summary & Overview
HCPCS Level II J9359: Loncastuximab Tesirine Injection, 0.075 mg
HCPCS Level II code J9359 denotes injection of loncastuximab tesirine-lpyl, charged per 0.075 mg unit. The code identifies administration of a targeted antibody‑drug conjugate used in oncology care and is integral to billing for outpatient chemotherapy services. Nationally, accurate use of this HCPCS Level II code supports consistent drug utilization reporting, claims processing, and reimbursement for high-cost specialty medications.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical and service context for J9359, typical sites of service, and the common modifiers associated with oncology drug administration. The content highlights what to expect for claims submissions and payer interactions without prescribing clinical or billing actions.
This publication outlines benchmark considerations and policy-relevant topics such as unit-based drug billing, site-of-service implications for outpatient infusion, and Medicare coverage relevance. Data elements not provided in the input—such as specific ICD-10 pairings, associated taxonomies, or payer-specific rate benchmarks—are noted as unavailable. The piece equips revenue cycle and clinical administrative teams with the code context needed for operational and policy discussions at a national level.
Billing Code Overview
HCPCS Level II code J9359 represents the medication loncastuximab tesirine-lpyl supplied for injection, billed per 0.075 mg unit. This code is used to report administration of the specified oncology agent.
Service Type: Injectable chemotherapy / targeted oncology therapy
Typical Site of Service: Outpatient infusion center or hospital outpatient department, where intravenous or parenteral oncology agents are administered.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) presents to the outpatient oncology infusion center for administration of loncastuximab tesirine-lpyl. The patient has been evaluated by a hematologist-oncologist who reviewed recent labs, imaging, and performance status. Pre-infusion workflow includes verification of diagnosis, weight-based dosing calculation, pharmacy compounding of the J9359 vial strength (0.075 mg), baseline vital signs, laboratory review (complete blood count, liver and renal function), and informed consent for intravenous targeted antibody-drug conjugate therapy.
On infusion day the patient is triaged by a registered nurse who confirms no active infections or contraindications, documents pre-medications if indicated (antiemetic or corticosteroid), and establishes IV access. The oncology pharmacist performs a final dose check, prepares the drug under aseptic conditions, and labels the infusion. The treating physician documents the plan of care and monitors for anticipated adverse events, including cytopenias, hepatic toxicity, and infusion-related reactions. Post-infusion monitoring occurs in the infusion suite with discharge instructions and scheduled follow-up visits for response assessment and toxicity management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
JW | Drug amount discarded/not administered |