2025 HCPCS code J9036

This code represents 1 mg of bendamustine hydrochloride (Belrapzo) administered intravenously.

Check with your payer for specific coding guidelines and whether the administration is separately reportable.If only a portion of a vial is used and the remainder is discarded, modifier JW might apply.

Modifiers may be applicable depending on the specific circumstances of administration and payer requirements.Review payer guidelines for appropriate modifier use (e.g., for drug amount discarded).

The administration of bendamustine hydrochloride (Belrapzo) must be medically necessary for the treatment of chronic lymphocytic leukemia (CLL) or indolent B-cell non-Hodgkin lymphoma (NHL), as determined by the treating physician.Appropriate documentation supporting the diagnosis and the rationale for the chemotherapy regimen is required.

Administration of the medication and monitoring the patient for adverse effects.Dosage adjustments based on patient response and tolerance are within the clinical responsibility of the administering physician.

IMPORTANT See J9033 for Treanda brand bendamustine HCl.Check with provider/payer if uncertain which code to report.

In simple words: This code is for a specific dose (1 milligram) of the cancer drug Belrapzo, given intravenously (through a vein).It's used to treat certain types of blood cancers.

This HCPCS code, J9036, represents 1 mg of the Belrapzo brand of bendamustine hydrochloride (HCl) administered by intravenous infusion to treat chronic lymphocytic leukemia (CLL) and indolent B-cell non-Hodgkin lymphoma (NHL).The recommended dosage varies depending on the indication and may be modified based on toxicity.Bendamustine HCl is supplied as a ready-to-dilute solution. This code represents the supply of the drug; check coding and payer guidelines to determine whether you can also report the administration.

Example 1: A 65-year-old male with CLL receives 100 mg/m² of Belrapzo intravenously on days 1 and 2 of a 28-day cycle for six cycles.Code J9036 would be reported for each 1 mg administered., A 70-year-old female with indolent B-cell NHL receives 120 mg/m² of Belrapzo intravenously on days 1 and 2 of a 21-day cycle for eight cycles.Code J9036 would be reported for each 1 mg administered., A patient experiences dose-limiting hematologic toxicity (e.g., thrombocytopenia). The physician reduces the dose of Belrapzo.Code J9036 will be reported for each 1mg of adjusted dose.Appropriate modifiers may be necessary based on the specific circumstances and payer guidelines.

* Physician order specifying the drug, dose, and route of administration.* Patient's diagnosis supporting medical necessity.* Documentation of the administration including date, time, and amount given.* Monitoring of the patient's response to the medication.* Documentation of any adverse events or medication adjustments.

** This code represents the supply of Belrapzo; the administration may be separately reportable depending on payer rules.Consult the Belrapzo package insert for complete prescribing information.

  • Payment Status: Active
  • Modifier TC rule: Not applicable; this code represents the drug supply.
  • Specialties:Hematology/Oncology
  • Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.