HCPCS Code J9022: Injection, Atezolizumab, 10 mg

Learn about the HCPCS code J9022 for injection, atezolizumab, 10 mg, through this short guide.

## **What is the HCPCS code J9022 for?** The HCPCS code J9022 is for a 10 mg dosage of atezolizumab, a medicine administered via injection. This medication is a popular choice for treating certain types of cancer and is approved for use in several indications, including extensive-stage small cell lung cancer (SCLC) and unresectable or metastatic hepatocellular carcinoma. It is also approved as an adjuvant treatment for stage II to III non-small cell lung cancer (NSCLC) that is positive for PD-L1 expression. This injection is administered intravenously for an hour every three weeks until disease progression or unacceptable toxicity. Atezolizumab works by targeting and binding to the protein programmed death-ligand 1 (PD-L1), which is found on tumor cells and tumor infiltrating immune cells. By blocking the interaction between PD-L1 and PD-1, atezolizumab enhances T-cell activation, helping the immune system to better detect and destroy cancer cells. This mechanism offers significant benefits, including better survivability and an improved quality of life for patients. While atezolizumab's approved uses are specific, the field of oncology is constantly evolving. Ongoing research and clinical trials are exploring the use of immune checkpoint inhibitors in a wide range of cancers, including those with ALK genomic tumor aberrations, epidermal growth factor receptor mutations, and conditions like metastatic melanoma and metastatic alveolar soft part sarcoma (ASPS). Such uses are not yet FDA-approved but remain under active study, aiming to expand treatment options and improve outcomes for more patients. This can benefit patients in such a way that they're able to have better survivability, live a longer life, and enjoy a better quality of life. It has also undergone an FDA-approved test for reliability and consistency, and the dosage is supported by practical guidelines and peer-reviewed medical literature, that's why it's a popular choice to treat the aforementioned cancers. Atezolizumab can be used on adult and pediatric patients, especially if they received prior systemic therapy that didn't work. There are ongoing clinical trials for using Atezolizumab on patients who will undergo liver transplant surgery to delay tumor growth or down-stage them, as a way to bridge them without increasing the risk of solid organ transplant rejection (Abdelrahim & The Methodist Hospital Research Institute, 2025).

## **Documentation requirements for J9022** As with any procedure, especially involving injecting drugs into pediatric or adult 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 and 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, including the drug manufacturer and NDC - Patient records showing they have been diagnosed with a specific cancer that this medication is known to treat - Blood test and imaging test results to check if the patient is suitable to take this medicine - Imaging test results showing locations and sizes of tumors - The exact dosage and route - Record of any adverse reactions to the medicine (if any)

## **Billing requirements for J9022** 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. For administration, use CPT codes for IV infusion. Typically, CPT 96365 applies to the initial hour of IV infusion, while subsequent hours or additional infusions may require different CPT codes (e.g., 96366). Always follow CMS/Medicare guideliness for coding and billing to avoid claim rejections.

## **Other similar codes** - J9023 - Injection, avelumab, 10 mg - J9302 - Injection, ofatumumab, 10 mg - J9035 - Injection, bevacizumab, 10 mg - J9312 - Injection, rituximab, 10 mg - J0565 - Injection, bezlotoxumab, 10 mg

### **Reference** Abdelrahim, M., & The Methodist Hospital Research Institute. (2025). Atezolizumab and bevacizumab pre-liver transplantation for patients with hepatocellular carcinoma beyond Milan criteria. National Library of Medicine; Clinicaltrials.gov. https://www.clinicaltrials.gov/study/NCT05185505?cond=Liver%20Cancer&viewType=Table&distance=50&aggFilters=status:rec&page=4&rank=31

Frequently asked questions

It's normal for the patient to feel fatigued and nauseated after taking this treatment. They might also have a weakened appetite. These are the most common adverse reactions. After administering the medicine to them, please keep an eye on them for a while to see if there are any infusion-related reactions. Rare complications include immune-mediated adverse reactions (e.g., immune-mediated hepatitis, immune-mediated colitis, immune-mediated nephritis).

Platinum-containing chemotherapy, other immunotherapy drugs, radiation therapy, and surgery.

The injection itself could take up to an hour. But it's best for you to monitor the patient for up to 2 to 3 hours just to see if there are any adverse reactions. If there are, please address those ASAP.