Oncology & Hematology Coding Alert

Question: What HCPCS code should I use for ixabepilone?

Tennessee Subscriber

Answer: You should report J9999 (NOC, antineoplastic drug). The FDA recently approved ixabepilone for breast cancer treatment, and HCPCS doesn't offer a specific code for this drug.

Important: Your claim for an unlisted code should include a description of the drug and the exact dose the patient received.

Check your payer: Tennessee Part B carrier Cigna, for example, includes ixabepilone coverage for metastatic or locally advanced breast cancer codes 174.0-175.9 in its "4th Quarter Update Part B Not Otherwise Classified Drug Fee Schedule," at www.cignagovernmentservices.com/partb/coverage/fees/noc/2007_Q4_NOC.html. You should include an invoice for payment.