HCPCS Code J9047: Injection, carfilzomib, 1 mg

## **J9047 documentation requirements** Thorough documentation ensures accurate unit calculation and payer compliance. ### **Diagnosis and clinical status** Record multiple myeloma with line of therapy (e.g., relapsed disease or refractory disease), prior regimens, and clinical rationale for carfilzomib as primary therapy, frontline treatment, or subsequent therapy based on the plan of care. ### **Dose, units, and schedule** Document patient weight, dose in milligrams, and exact J9047 units (1 mg = 1 unit), plus cycle/day schedule and any dose adjustments related to disease progression or toxicity. ### **Infusion details and technique** Capture site of care, route, start/stop times, and intravenous infusion technique (initial hour and any additional time), along with premedications and concurrent agents used in combination therapy. ### **Drug identifiers and vial usage** Include brand/generic name, strength, NDC, lot number, expiration date, and single-dose vial utilization. Clearly separate administered vs. discarded amounts in the note. ### **Monitoring, safety, and adverse events** Document vitals, labs, and any notable toxicities, including cardiovascular events (myocardial infarction, myocardial ischemia, pulmonary hypertension), renal effects (acute renal failure), neurologic findings (posterior reversible encephalopathy syndrome), and other infusion reactions.

## **J9047 billing requirements** Follow these guidelines to avoid denials and assure clean claims. ### **Unit accuracy** Bill J9047 per 1 mg actually administered. Units on the claim must match the documented dose without rounding. ### **JW/JZ wastage policy** For a single-dose vial, bill the administered amount on one line; if wastage occurs, bill the discarded amount on a separate line with JW. Use JZ when no drug was discarded. ### **Chemotherapy administration codes** Pair the drug with appropriate chemotherapy administration codes reflecting IV push or infusion (see “Other relevant codes”) based on the documented intravenous infusion technique. ### **NDC, place of service, and dates** Report the correct NDC on Part B claims; ensure site of service and dates/times align across the order, MAR, and claim. ### **Authorization and coverage** Verify medical necessity, prior authorization, and payer rules for covered services, especially for regimens used as maintenance therapy or frontline treatment in transplant candidates.

## **J9047 applicable modifiers** Use modifiers to accurately represent wastage and meet payer requirements: - **JW** **- Drug amount discarded/not administered:** Append to the line representing the discarded portion from a single-dose vial when documented waste occurs. - **JZ** **- Zero drug wasted:** Append when the entire contents of the single-dose vial were used with no wastage (required on many Medicare claims). - **99** **- Multiple modifiers (when required):** Use if the payer requires multiple modifier reporting on the same service line. Always confirm payer-specific rules before adding programmatic modifiers beyond JW/JZ.

## **Other relevant codes** Select chemotherapy administration codes based on how carfilzomib was delivered and session specifics: - **96413** – Chemotherapy administration, IV infusion; up to 1 hour, initial substance/drug. - **96415** – Each additional hour of chemotherapy IV infusion (list separately in addition to 96413). - **96417** – Each additional sequential chemotherapy infusion of a different drug, up to 1 hour. - **96409** – Chemotherapy administration, IV push, single or initial substance/drug. - **96411** – Each additional or sequential chemotherapy IV push of a new substance/drug