Oncology & Hematology Coding Alert

Question: Does HCPCS offer a specific J Code for Ixempra yet?

Colorado Subscriber

Answer: Ixempra has no specific J code yet, but physician offices commonly bill it with the temporary J code J9999 (NOC, antineoplastic drug).

Ixempra has two different dosage sizes, 15 mg and 45 mg. The National Drug Code for 15 mg is 0015191012, and for 45 mg it's 0015191113. When you-re filling out claims, use the NDC and a description of the med in box 19 along with a malignant breast neoplasm diagnosis code from 174.0-175.9.

What it is: Ixempra received FDA approval in October 2007 for use in patients with metastatic or locally advanced breast cancer who have not responded to certain other cancer drugs. The FDA evaluated Ixempra under priority review, completing its assessment of the drug's safety and effectiveness in six months.

According to Ixempra's official site, "Ixempra is indicated as monotherapy for the treatment of metastatic or locally advanced breast cancer in patients whose tumors are resistant or refractory to anthracyclines, taxanes, and capecitabine." The manufacturers recommend putting the NDC on your claims.

For hospital coders only: As of Jan. 1, hospitals should bill Ixempra under the Outpatient Prospective Payment System with C9240 (Injection, ixabepilone, 1 mg).

A note of caution: Code C9240 is not for physician office billing.