## **What is the HCPCS code J9299 for?**
The HCPCS code J9299 is a J code. J codes are HCPCS codes that are mostly meant to designate injected medicine. For J9299, what is being injected is nivolumab, specifically a 1 mg dosage.
The purpose of the nivolumab injection is to serve as a form of immunotherapy that helps with combating certain cancers. Such cancers include breast cancer, ALK genomic tumor aberrations, non-small cell lung cancer, kidney cancer, (unresectable) melanoma, metastatic melanoma, Hodgkin lymphoma, and more. What this medicine does is to help a patient's immune system recognize and attack cancer cells, which will result in the shrinking of tumors and slower progression of the cancer.
Besides the indications listed above, it's best to confirm if the patient hasn't responded well to other forms of treatment.
Also, this injected medication is administered via intravenous infusion technique as part of chemotherapy administration.
## **Documentation requirements for J9299**
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, including the drug coding information
- Patient records showing they have been diagnosed with a cancer eligible for this treatment to support medical necessity
- Blood test results
- Imaging test results showing locations and sizes of tumors
- The exact dosage (1 mg = 1 unit)
## **Billing requirements for J9299**
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.
Please also use the appropriate ICD code based on the patient's cancer diagnosis. Since this injection is done intravenously, please use CPT code 96365.
Please familiarize yourself with CMS guidelines, Medicaid services guidelines, mandates by Medicare, etc. This is to avoid claim rejections and ensure smooth billings.
## **Other similar codes**
- **J9228** - Injection, ipilimumab, 1 mg
- **J9271** - Injection, pembrolizumab, 1 mg
- **J9309** - Injection, polatuzumab vedotin-piiq, 1 mg
- **J3380** - Injection, vedolizumab, intravenous, 1 mg
- **J2323** - Injection, natalizumab, 1 mg
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