HCPCS J9354

Injection, ado-trastuzumab emtansine, 1 mg

HCPCS Information

HCPCS Code: J9354
The Healthcare Common Procedure Coding System (HCPCS) is a set of unique alphanumeric codes used to report medical procedures and services to healthcare programs like Medicare and Medicaid. HCPCS codes are used in conjunction with NDC codes for billing and medical documentation puporses. For instance, HCPCS J9354 identifies the type of service or supply used while any of the 2 NDC codes below could be used to specify the exact drug used.
Short Description
Inj, ado-trastuzumab emt 1mg
Long Description
Injection, ado-trastuzumab emtansine, 1 mg
Pricing Indicator
Drugs
Multiple Pricing Indicator
Not applicable as HCPCS priced under one methodology
Coverage Description
Carrier judgment
BETOS Type of Service
Chemotherapy
Medicare Payment Limit
$41.85
Medicare Co-Insurance Percentage
19.821%
Medicare Pricing Notes
Inflation-adjusted coinsurance
HCPCS Classification
List of HCPCS codes for: Drugs Administered Other Than Oral Method, Chemotherapy Drugs (J-codes)

HCPCS Crossover to NDC Codes

The NDC codes below allow precise billing based on the specific manufacturer and medication used:

NDC Proprietary Name Non-Proprietary Name Dosage Form Route Name Company Name Status
50242-087Kadcyla Ado-trastuzumab EmtansineInjection, Powder, Lyophilized, For SolutionIntravenousGenentech, Inc.ACTIVE
50242-088Kadcyla Ado-trastuzumab EmtansineInjection, Powder, Lyophilized, For SolutionIntravenousGenentech, Inc.ACTIVE