## **What is the HCPCS code J9263 for?**
The HCPCS code J9263 is meant to designate the injection of oxaliplatin, specifically a 0.5 mg dosage.
Oxaliplatin is one of many chemotherapy drugs. This one in particular is known for being used to treat colorectal cancers (e.g., metastatic carcinoma, advanced colorectal cancer, etc.). It can also be used to treat ovarian cancer. Other indications include the patient being suitable for chemotherapy and if their physician determines the need to use this medicine.
This specific drug is injected into the bloodstream. Its goal is to inhibit malignant neoplasm/tumor growth by slowing down or stopping the growth of cancer cells, or to eliminate them. Doing either of these will shrink tumors.
Please note that this drug cannot be self-administered. This is administered intravenously. It is sometimes combined with other chemotherapy agents, like gemcitabine hydrochloride.
## **Documentation requirements for J9263**
As with any injected medication, J9263 requires sufficient documentation for your claim to be approved. Here are several of what you need:
- The full name of the patient
- The full name and credentials of the professional who administered the injection
- The date and time of the drug administration by injection, including start and stop times of the infusion
- The name and address of the facility where the injection was administered
- Patient records showing they have been diagnosed with colorectal cancer or other cancers that this medicine often treats
- Blood test results
- Imaging test results showing the locations and sizes of tumors
- The exact dosage/total amount administered
## **Billing requirements for J9263**
Besides the documentation requirements above, please make sure to take note of or have the following:
- The necessary ICD code related to your patient's cancer
- Physician's order for oxaliplatin, including dosage and route of administration
- Drug name, lot number, manufacturer information, and FDA-approved labeling
- Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication
- CPT code 96365 since this injection is administered intravenously
Please make sure that you are familiar with CMS/Medicare coverage/related guidelines and policy articles concerning injected medication. Practice correct coding guidelines to avoid claim rejections.
## **Other similar codes**
- **J9120** - Injection, dactinomycin, 0.5 mg
- **J9045** - Injection, carboplatin, 50 mg
- **J9351** - Injection, topotecan, 0.1 mg
- **J0223** - Injection, givosiran, 0.5 mg
- **J9267** - Injection, paclitaxel, 1 mg
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