Reader Questions:
Match J9303 to Chemo Admin Codes
Published on Sun Jun 27, 2010
Question: I had a claim for J9303, 96413, and +96367 rejected. Are these the correct administration codes for this drug?Wisconsin SubscriberAnswer: The most likely problem is the pairing of J9303 (Injection, panitumumab, 10 mg) with non-chemotherapy additional sequential infusion code +96367 (Intravenous infusion, for therapy, prophylaxis, or diagnosis [specify substance or drug]; additional sequential infusion, up to 1 hour [List separately in addition to code for primary procedure]).Here's why: Code J9303 represents panitumumab (sold as Vectibix), a monoclonal antibody. Unless your payer tells you otherwise in writing, you should report panitumumab administration using the chemotherapy administration codes. So assuming you intended the codes to report a panitumumab infusion lasting between 91 and 150 minutes, the correct administration codes would be initial hour code 96413 (Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug) and the code representing an additional hour of chemo administration, +96415 (... each [...]