## **What is the HCPCS code J1626 for?**
The HCPCS code J1626 is one of the many J codes you can use. J HCPCS codes are a massive cluster of codes meant to designate the use of injected medication. For J1626, it is specifically for the injection of granisetron HCL (hydrochloride), specifically a dosage of 100 mcg.
Granisetron hydrochloride is an anti-nausea drug. It helps prevent patients from experiencing nausea (and, in turn, vomiting) during certain procedures, specifically surgical procedures (specifically during post-op recovery), chemotherapy, or radiation therapy. By reducing nausea and vomiting, patients will have a better quality of life during such procedures.
Of course, this is not exclusive to patients who will undergo such procedures. This can be used on patients who are simply prone to nausea.
## **Documentation requirements for J1626**
As with any procedure, especially involving injecting drugs into patients, it's important to document the following before you file for a claim that includes this code:
- The full name of the personnel who administered the injection + their credentials
- The name and address of the facility where the injection was administered
- The full name of the patient
- The date and time of the drug administration by injection
- Patient records showing they have been diagnosed with medical conditions that require chemotherapy, radiation therapy, or surgery, complete with symptoms they've been experiencing and reasons for these specific treatments
- If the patient is just prone to nausea, it's best to include medical records showing that
- Blood test results
- List of over-the-counter medicine, prescribed medicine, and supplements the patient is using
- Imaging test results showing locations and sizes of tumors (if the patient has cancer)
- Medical necessity
- The exact dosage and route
## **Billing requirements for J1626**
Besides the documentation requirements above, please note the following billing requirements for this HCPCS code:
- They must reflect the dosage given over the course of the treatment.
- Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication.
This injection is done intramuscularly, so please use the CPT code 96365.
Please also use the appropriate diagnosis codes as well based on the reason for the use of the medicine.
Dosages going beyond 100 mcg must be billed separately.
Frequently asked questions
