HCPCS Code J9317: Injection, Sacituzumab Govitecan-hziy, 2.5 mg

HCPCS Code J9317 is used to bill for sacituzumab govitecan-hziy, a drug given via intravenous infusion to treat certain cancers, including triple-negative breast cancer and metastatic urothelial cancer, after prior treatment.

Yes, Medicare may cover J9317 when it meets NCCN clinical practice guidelines and other CMS criteria, such as documented disease progression following at least two lines of therapy or unacceptable toxicity from prior treatment.

Medical records should indicate the cancer type, stage, prior therapies, and clinical justification for sacituzumab govitecan-hziy. Documentation must also include the dose, infusion details, and any adverse or infusion-related reactions.