Receiving Helpdesk

what is cpt code j9312

by Willie Brekke III Published 3 years ago Updated 2 years ago

Group 1
CodeDescription
J9311INJECTION, RITUXIMAB 10 MG AND HYALURONIDASE
J9312INJECTION, RITUXIMAB, 10 MG
Q5115INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MG
Q5119INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG
1 more row

What is CPT J9312 used for?

HCPCS code J9312 for Injection, rituximab, 10 mg as maintained by CMS falls under Chemotherapy Drugs.

What is the code for Rituximab?

Rituximab (Rituxan) HCPCS code J9310 Rituximab, 100 mg, injection: Billing Guidelines.

What is the difference between J9311 and J9312?

Effective January 1, 2019 J-code J9312 will replace J9310 for RITUXAN and the billable units will change from 100 mg to 10 mg. Additionally, the permanent J-code assigned for RITUXAN HYCELA is J9311. The RITUXAN AND RITUXAN HYCELA J-Code Flash Card, attached to this email, details the new J-code information.

How do you bill rituximab?

CPT/HCPCS Codes Effective for dates of service 7/1/2021 and after, HCPCS code Q5123 should be used to report rituximab-arrx (Riabni™). For dates of service prior, 12/17/2020 through 6/30/2021, HCPCS code C9399 should be used for Part A and HCPCS code J3590 should be used for Part B to report rituximab-arrx (Riabni™).

What is the generic name for RITUXAN?

Rituxan is the trade name for rituximab. In some cases, health care professionals may use the trade name rituxan when referring to the generic drug name rituximab. Drug type: Rituximab is a monoclonal antibody. (For more detail, see "How this drug works" section below).

Is rituximab a chemotherapy?

RITUXAN is not chemotherapy. RITUXAN is a type of antibody therapy that can be used alone or with chemotherapy. They work in different ways to find and attack the cells where cancer starts. RITUXAN targets and attaches to the CD20 protein found on the surface of blood cells with cancer and some healthy blood cells.

Are Rituxan and Rituxan Hycela the same?

You may wonder how Rituxan Hycela and Rituxan are alike and different. Rituxan Hycela and Rituxan are used to treat certain cancers. Both drugs are given as injections by a healthcare professional. Rituxan Hycela is given as an injection under your skin, while Rituxan is given as an intravenous (IV) infusion.

What type of monoclonal antibody is rituximab?

Rituximab, a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20, was the first monoclonal antibody to be approved for therapeutic use.

What is the J code for Remicade?

The product-specific HCPCS code for REMICADE® is J1745, infliximab, 10 mg. It is important to note that this code represents 1/10th of a vial.

What class of drug is RITUXAN?

Rituximab injection (Rituxan) is used to treat pemphigus vulgaris (a condition that causes painful blisters on the skin and the lining the mouth, nose, throat and genitals). Rituximab injection products are in a class of medications called monoclonal antibodies.

What is the J code for rituximab-Abbs?

Group 2CodeDescriptionJ3590UNCLASSIFIED BIOLOGICSJ9312INJECTION, RITUXIMAB, 10 MGQ5115INJECTION, RITUXIMAB-ABBS, BIOSIMILAR, (TRUXIMA), 10 MGQ5119INJECTION, RITUXIMAB-PVVR, BIOSIMILAR, (RUXIENCE), 10 MG

Is RITUXAN used for hemolytic anemia?

Rituximab is becoming the preferred second-line choice for steroid-refractory warm autoimmune hemolytic anemia (wAIHA) and the first-line choice for cold agglutinin disease (CAD).

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

This article contains billing and coding guidelines that complement the Local Coverage Determination (LCD) Drugs and Biologicals, Coverage of, for Label and Off-Label Uses. Rituximab and biosimilars are CD20-directed cytolytic antibodies. Rituximab and hyaluronidase human is a combination of rituximab, a CD20-directed cytolytic antibody, and hyaluronidase human, an endoglycosidase. Utilization: Dose and frequency should be in accordance with the FDA label or recognized compendia (for off-label uses).

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

HCPCS Code Details - J9311

Effective Jan 01, 2019 - This procedure is approved to be performed in an ambulatory surgical center.

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

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