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Degarelix Code

  1. #1
    Default Degarelix Code
    Exam Training Packages
    Does anyone have a HCPCS for this drug? we were told to use the J9999...couldnt find anything else jsut wondering if anyone had something..

    Thanks,
    Deyna

  2. #2
    Default
    Hi Deyna,

    So far there has been no specific CPT code assigned to Degarelix/Firmagon.
    It is correct that you will use J9999 until that happens.

  3. #3
    Default
    J3490
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    Effective: 01/01/1994 *


    MedAssets Notes:
    Alfentanil Hcl 500 MCG; Allopurinol Sodium 500 MG; Aminocaproic acid 250 MG; Arginine Hydrochloride 300 ML; Ascorbic Acid 250 MG; Atropine Sulfate/Edrophonium Chloride 10 MG; Aztreonam 500 MG; Bumetanide 0.25 MG; Bupivacaine, 0.25% 1 ML; Bupivacaine, 0.50% 1 ML; Bupivacaine, 0.75% 1 ML; Calcium Chloride 100 MG; Certolizumab Pegol 1 MG (see also C9249); Cimetidine Hydrochloride 150 MG; Clavulanate Potassium/Ticarcillin Disodium 0.1-3 GM; Clevidipien Butyrate 1 MG (see also C9248); Clindamycin Phosphate 150 MG; Copper Sulfate 0.4 MG; Cosyntropin IV .25 MG; Degarelix 1 MG (3Q2009); Diltiazem Hydrochloride 5 MG; Doxapram HcL 20 MG; Doxycycline Hyclate 100 MG; Dysport 1 UN (4Q2009); Edrophonium Chloride 10 MG; Enalaprilat 1.25 MG; Esmolol Hydrochloride 10 MG; Esomeprazole Sodium 20 MG; Etomidate 2 MG; Famotidine 10 MG; Feraheme 1 MG (4Q2009); Flumazenil 0.1 MG; Folic Acid 5 MG; Gadoxetate Disodium 1 ML (see also C9246); Glycopyrrolate 0.2 MG; Integra Meshed Bilayer Wound Matrix 1 SQ CM (3Q2009); Ketamine Hcl 10 MG; Labetalol Hcl 5 MG; Lidocaine 1 ML; Metoprolol Tartrate 1 MG; Metronidazole inj 500 MG; Morrhuate Sodium 50 MG; Nafcillin Sodium 1 GM; Nitroglycerin 5 MG; Olanzapine 0.5 MG; Plerixafor 1 MG (3Q2009); Potassium Acetate 2 MEQ; Potassium Phosphate 3 MMOL; Propofol 10 MG; Protonix 40 MG (see also C9113); Rifampin 600 MG; Romiplostim 10 MCG (see also C9245); Sarracenia Purpura 1 ML; Sodium Acetate 2 MEQ; Sodium Bicarbonate, 8.4% 50 ML; Sodium Chloride, Hypertonic 250 CC; Sodium thiosulfate 100 MG; Sulfamethoxazole-Trimethoprim 400-80 MG; SurgiMend 0.5 SQ CM (see also C9358); Synvisc-ONE 48 MG; Valproate Sodium 100 MG; Vasopressin 20 UNITS; Vecuronium bromide 1 MG; Verapamil Hcl 2.5 MG; Xyntha 1 IU (1Q2009)
    NOC drugs removed for 2009: Bendamustine HcL 1 MG (see also C9243); Doripenem 10 MG (see also C9241); Fosaprepitant 1 MG (see also C9242); Ixabepilone 1 MG; Lanreotide 1 MG (see also C9237); Levetiracetam (Keppra intraveneous) 10 MG (see also C9238); Nalmefene HcL 10 MCG; Regadenoson 0.4MG (see also C9244); Temsirolimus PER 25 MG KIT (see also C9239); Triamcinolone Acetonide, Preservative Free 1 MG

  4. Default Dking
    We are having the same problem with the j9999 or j3490 can you please advise on the correct one?
    Thanks

  5. #5
    Default Degarelix
    Code J9999 would be appropriate as it is an antineoplastic.

  6. Default
    When you use an unlisted code, you must include the NDC # 55566840101

  7. Default
    Yes, you have to use the J9999. But, becareful because there is an initial starter dose of 240 mg and then the patient gets a monthly maintanence dose of 80 mg. You have to drop the claim to paper and include the NDC (National Drug Code) to submit to the insurance.

    Plus, your injection code 96402.

  8. #8
    Default
    FYI ... as of 01/01/2010 code J9155 will be assigned to Degarelix (Firmagon), this is per CMS
    Sincerely,

    Kristie Stokes, CPC, CPMA, CCS, CMDP, ICDCT-CM

    AAPCCA Board of Directors 2014-2017
    Region 1 - Northeast
    Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York

    Today, give a stranger one of your smiles. It might be the only sunshine they see all day.

  9. #9
    Default
    thank you!!!

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