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2025 HCPCS code J9176

Injection, elotuzumab, 1 mg; represents the drug supply only, not administration.

Follow CMS and payer guidelines for HCPCS coding. Pay close attention to requirements for reporting discarded medication (modifier JW).

Modifiers may be applicable, such as JW (drug discarded) and potentially others depending on the circumstances of administration. Consult payer guidelines.

Elotuzumab is medically necessary for treating multiple myeloma as per FDA approval. Documentation must support the diagnosis of multiple myeloma and demonstrate that the patient meets the criteria for receiving this treatment.

Physicians or other qualified healthcare providers administer elotuzumab intravenously.This code covers only the drug supply; administration requires additional codes.

IMPORTANT No specific alternate codes are listed, but the administration of elotuzumab would require separate procedural codes depending on the method used.

In simple words: This code is for a single dose (1 mg) of the cancer medicine elotuzumab.It's only for the cost of the medicine itself, not the cost of giving the injection.

HCPCS code J9176 represents the supply of 1 mg of elotuzumab, a humanized IgG1 monoclonal antibody targeting the SLAMF7 protein expressed on myeloma cells.It works by activating natural killer cells to kill myeloma cells through antibody-dependent cellular cytotoxicity (ADCC). This code is for the drug supply; separate codes are needed for administration.

Example 1: A patient with multiple myeloma receives 1 mg of elotuzumab as part of their chemotherapy regimen. J9176 is reported for the drug supply.Administration codes would be reported separately., In an outpatient oncology clinic, a patient is given 10 mg of elotuzumab (requiring 10 units of J9176) as part of their treatment plan. Again, J9176 represents only the drug, while administration needs further codes., A portion of elotuzumab is discarded due to a change in the patient's clinical status. Code J9176 is used for the administered portion, and modifier JW is used to report the discarded amount.

* Diagnosis supporting the medical necessity for elotuzumab (e.g., multiple myeloma).* Documentation of the amount of elotuzumab administered.* If any portion of elotuzumab was discarded, documentation of the discarded amount.

** Always refer to the most up-to-date CMS HCPCS guidelines and individual payer policies for accurate coding and reimbursement.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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