## **What is the HCPCS code J9267 for?**
The HCPCS code J9267 is a J code and one of many that are meant to designate injected medication. This code designates the provision of a paclitaxel injection, specifically every 1 mg dose of it.
Paclitaxel injections are often used to treat certain cancers. These include the following indications: squamous cell carcinoma, metastatic breast cancer, gastric cancer, bladder cancer, endometrial carcinoma, non-small cell lung cancer, cutaneous melanoma, ovarian cancer, and other metastatic diseases.
What this injection does is inhibit and stop the growth of cancer cells, reduce the size of tumors, prevent the cancer from spreading, and help the patient achieve remission.
Please note that this is an intravenous injection. It can't be self-administered.
## **Documentation requirements for J9267**
Like any HCPCS code, you'll need to prepare documentation that satisfies the coding information requirements set by your insurer, along with any related policy codes and local coverage determinations applicable to you. Here are examples of what you might need:
- The full name of the patient
- The full names and credentials of the professionals handling the patient
- The name, address, and type of facility where the injection was administered
- Physician's order
- The relevant information and indications related to your patient's medical record and current condition to justify medical necessity
- Drug information (e.g., drug name, total dose given, route of administration, lot number, manufacturer, National Drug Code, etc.)
- Infusion start and stop times
- Imaging tests showing the size and locations of malignant neoplasms
- Documentation of prior therapies provided to the patient with proof that they didn't respond well to the treatment/the treatment didn't work at all, or only partially; documentation must also include the use of anthracycline as part of the prior therapy, unless clinically contraindicated
## **Billing requirements for J9267**
Besides the documentation requirements above, please make sure to take note of or have the following:
- 1 mg = 1 unit of service (e.g., 10 mg = 10 units of service)
- Use the appropriate ICD codes applicable to your patient's condition
- Use appropriate infusion CPT administration codes (e.g., 96413 for the first hour of chemo infusion, 96415 for each additional hour).
- Covered under Medicare Part B (when medically necessary for cancer treatment)
- Use either of two modifiers: JW if there's unused medication in a vial (wastage), or JZ if there's no unused medication.
## **Other similar codes**
- **J9264** - Injection, paclitaxel protein-bound particles, 1 mg
- **J9171** - Injection, docetaxel, 1 mg
- **J9043** - Injection, cabazitaxel, 1 mg
- **J9271** - Injection, pembrolizumab, 1 mg
- **J9306** - Injection, pertuzumab, 1 mg
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