Medications Used for the Treatment of Kidney Cancers and Their Associated ICD-10 Codes

Kristin A. Esposito, CPhT

February 2017, Vol 7, No 2 - Cancer Drug Coding


This detailed article of codes related to kidney cancers is intended to assist practice managers and other healthcare providers and payers to ensure the proper use of coding and billing information associated with the treatment of patients with kidney cancers.

The following sections include:

  • Associated ICD-10-CM codes used for the classification of kidney cancers
  • Drugs that have been approved by the FDA for the treatment of kidney cancers
  • Drugs that are Compendia-listed for off-label use for kidney cancers based on clinical studies that suggest beneficial use in some cases. Please note: If a check mark appears in the FDA column, it will NOT appear in the Compendia off-label use column
  • Corresponding HCPCS/CPT® codes and code descriptions
  • Possible CPT® administration codes for the drugs

Associated ICD-10-CM Codes:

C64 Malignant neoplasm of kidney, except renal pelvis
  C64.1 Malignant neoplasm of right kidney, except renal pelvis
  C64.2 Malignant neoplasm of left kidney, except renal pelvis
  C64.9 Malignant neoplasm of unspecified kidney, except renal pelvis
C65 Malignant neoplasm of renal pelvis
  C65.1 Malignant neoplasm of right renal pelvis
  C65.2 Malignant neoplasm of left renal pelvis
  C65.9 Malignant neoplasm of unspecified renal pelvis
C68 Malignant neoplasm of other and unspecified urinary organs
  C68.9 Malignant neoplasm of urinary organ, unspecified
Generic (brand) name HCPCS code—code description FDA approved for kidney cancers Compendia off-label uses for kidney cancers Possible CPT® administration codes
aldesleukin (Proleukin) J9015 – Injection, aldesleukin, per single-use vial   96409
axitinib (Inlyta) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
axitinib (Inlyta) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
bevacizumab (Avastin) J9035 – Injection, bevacizumab, 10 mg   96413, 96415
cabozantinib (Cabometyx) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
cabozantinib
(Cabometyx)
J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
capecitabine (Xeloda) J8520 – Capecitabine, oral, 150 mg   N/A
capecitabine (Xeloda) J8521 – Capecitabine, oral, 500 mg   N/A
carboplatin (Paraplatin) J9045 – Injection, carboplatin, 50 mg   96409, 96413, 96415
cyclophosphamide (Cytoxan) J8530 – Cyclophosphamide, oral, 25 mg   N/A
cyclophosphamide (Cytoxan) J9070 – Cyclophosphamide, 100 mg   96409, 96413, 96415
dactinomycin (Cosmegen) J9120 – Injection, dactinomycin, 0.5 mg   96409
doxorubicin HCl (Adriamycin) J9000 – Injection, doxorubicin hydrochloride, 10 mg   96409
etoposide (Vepesid) J8560 – Etoposide, oral, 50 mg   N/A
etoposide (Etopophus, Toposar) J9181 – Injection, etoposide, 10 mg   96413, 96415
everolimus (Afinitor) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
everolimus (Afinitor) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
floxuridine (FUDR) J9200 – Injection, floxuridine, 500 mg   96422, 96423, 96425
fluorouracil (Adrucil) J9190 – Injection, fluorouracil, 500 mg   96409
gemcitabine (Gemzar) J9201 – Injection, gemcitabine hydrochloride, 200 mg   96413
ifosfamide (Ifex) J9208 – Injection, ifosfamide, 1 g   96413, 96415
interferon alfa-2b (Intron-A) J9214 – Injection, interferon, alfa-2b, recombinant, 1 million units   96372, 96401
interferon gamma-1b (Actimmune) J9216 – Injection, interferon, gamma-1b, 3 million units   96372
medroxyprogesterone acetate (Depo-Provera 400 mg only) J1050 – Injection, medroxyprogesterone acetate, 1 mg   96372, 96402
methotrexate J9250 – Methotrexate sodium, 5 mg   96372, 96374, 96401, 96409, 96450
methotrexate J9260 – Methotrexate sodium, 50 mg   96372, 96374, 96401, 96409, 96450
nivolumab (Opdivo) J9299 – Injection, nivolumab, 1 mg   96413, 96415
pazopanib (Votrient) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
pazopanib (Votrient) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
peginterferon alfa-2a (Pegasys) J3590* – Unclassified biologics   96372
peginterferon alfa-2a (Pegasys) S0145 – Injection, pegylated interferon alfa-2a, 180 mcg/mL   96372
pemetrexed (Alimta) J9305 – Injection, pemetrexed, 10 mg   96409
sargramostim (Leukine) J2820 – Injection, sargramostim
(GM-CSF), 50 mcg
  96365, 96366, 96372
sorafenib (Nexavar) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
sorafenib (Nexavar) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
sunitinib (Sutent) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
sunitinib (Sutent) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
temsirolimus (Torisel) J9330 – Injection, temsirolimus, 1 mg   96413
thalidomide (Thalomid) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
topotecan (Hycamtin) J9351 – Injection, topotecan, 0.1 mg   96413
vinBLAStine (Velban) J9360 – Injection, vinblastine sulfate,
1 mg
  96409
vinCRIStine (Vincasar PFS) J9370 – Vincristine sulfate, 1 mg   96409
*When billing a nonclassified medication using a CMS 1500 claim form you must include both the HCPCS code (eg, J8999 for Afinitor) in Item 24D and the drug name, strength, and NDC (National Drug Code) in Item 19 or 24A (shaded area) to ensure appropriate reimbursement. Please note: Check with your payer regarding the correct placement of medication information.
References
• HCPCS Level II Expert 2017
Current Procedural Terminology (CPT®) 2017
CPT Copyright © 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association
ICD-10-CM for Professionals Volumes 1 & 2 2017
• FDA-approved indication (product Prescribing Information)
• Compendia references available upon request
• www.ReimbursementCodes.com powered by RJ Health Systems International, LLC, Rocky Hill, CT
• CMS (Centers for Medicare & Medicaid Services)
GM-CSF indicates granulocyte-macrophage colony-stimulating factor; HCPCS, Healthcare Common Procedure Coding System.
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