2025 HCPCS code J9286

Injection, glofitamab-gxbm, 2.5 mg

Report one unit of J9286 for every 2.5 mg of glofitamab-gxbm administered. If only a portion of a single-dose vial is used and the remainder is discarded, modifier JW might be applicable, depending on payer-specific guidelines.

Modifier JW may be applicable to report wasted drug amounts.

Medical necessity for glofitamab-gxbm is typically established by documentation supporting the diagnosis of lymphoma, usually relapsed or refractory diffuse large B-cell lymphoma (DLBCL), along with documentation of prior treatments and the clinical rationale for using glofitamab-gxbm.

Administering glofitamab-gxbm intravenously, typically for lymphoma treatment, at a standard dosage of 30 mg post step-up phase. The drug is available in 2.5 mg/2.5 mL and 10 mg/10 mL single-dose vials. Reporting this code for every 2.5 mg of the drug administered.

In simple words: This code represents a 2.5 mg injection of glofitamab-gxbm, a medicine used to treat lymphoma (cancer of the lymph nodes). It's given through a vein.

Glofitamab-gxbm is administered intravenously, typically for the treatment of lymphoma. The usual dosage is 30 mg after a step-up phase. It's supplied in single-dose vials of 2.5 mg/2.5 mL and 10 mg/10 mL. This code is reported for each 2.5 mg of glofitamab-gxbm.

Example 1: A patient with relapsed or refractory diffuse large B-cell lymphoma receives 30 mg of glofitamab-gxbm intravenously after completing the step-up phase. Twelve units of J9286 are reported (30mg / 2.5mg/unit = 12 units)., A patient receives a reduced dose of 15 mg glofitamab-gxbm due to side effects experienced during the step-up phase. Six units of J9286 are reported., A patient receives glofitamab-gxbm, and a portion of a single-dose vial needs to be discarded. Modifier JW may be appended to J9286 to indicate the wasted drug, depending on payer guidelines.

Documentation should include the diagnosis (lymphoma type), dosage of glofitamab-gxbm administered, route of administration (intravenous), and the medical necessity for the treatment.

** J9286 represents the drug itself, not the administration. It's essential to verify payer guidelines regarding separate reporting for administration and drug supply. The brand name for glofitamab-gxbm is Columvi.

  • Payment Status: Active
  • Specialties:Oncology, Hematology
  • Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Clinic
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.