Summary & Overview
HCPCS Level II C9308: Injection, carboplatin (avyxa), 1 mg
HCPCS Level II code C9308 represents the drug-only billing entry for carboplatin (avyxa) at a unit of 1 mg. As a per-milligram antineoplastic drug code, it matters nationally because it directly affects how oncology drug costs are itemized on medical claims and tied to dosing-based reimbursement for outpatient infusion services. Accurate use influences payment, patient cost-sharing, and inventory reporting for chemotherapy providers.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how C9308 is used in practice, standard sites of service where the drug is administered, and the implications for billing when a drug is reported on a medical claim separate from administration services. The publication outlines common charge-unit practices for per-milligram chemotherapy codes, considerations for claim line reporting, and how coding ties to drug acquisition and reimbursement workflows.
This summary provides national context for providers, billers, and policy stakeholders seeking clarity on drug-specific HCPCS reporting. Data not available in the input is noted where applicable; the document focuses on code definition, service context, payer coverage scope, and areas where policy or billing guidance typically applies.
Billing Code Overview
HCPCS Level II code C9308 denotes an injection of carboplatin (avyxa), 1 mg. This code represents a chemotherapy agent administration at a per-milligram reporting unit and is used to capture the drug product provided for infusion or injection.
Service type: Antineoplastic chemotherapy drug administration (drug only)
Typical site of service: Hospital outpatient infusion center, physician office infusion suite, or ambulatory infusion clinic
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient receiving intravenous chemotherapy for a solid tumor such as ovarian carcinoma, lung cancer, or bladder cancer. The order is for C9308 (injection, carboplatin (avyxa), 1 mg). The clinical workflow begins with the oncologist documenting the treatment plan and indication, including an ICD-10 diagnosis and planned dosing based on body surface area or AUC. Pharmacy compounds or prepares the carboplatin dose, verifies concentration and compatibility, and labels the syringe or infusion bag. Nursing performs baseline assessments (vitals, lab review including CBC and creatinine), obtains venous access, and administers the drug per protocol, with infusion pumps and appropriate antiemetic premedication as ordered. Vital signs and patient tolerance are monitored during and after infusion. Billing uses C9308 with dose-based quantity reflecting milligrams administered and may include procedure-level CPTs for infusion administration and venous access as part of the encounter.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | When a separate, distinct service or procedure is performed on the same day and not normally billed together with the infusion administration codes |