Medications Used for the Treatment of Multiple Myeloma and Associated ICD-10 Codes

Kristin A. Esposito, CPhT

March 2017, Vol 7, No 3 - Cancer Drug Coding


This detailed article of codes related to multiple myeloma 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 multiple myeloma.

The following sections include:

  • Associated ICD-10-CM codes used for the classification of multiple myeloma
  • Drugs that have been approved by the FDA for the treatment of multiple myeloma
  • Drugs that are Compendia-listed for off-label use for multiple myeloma 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:

C90 Multiple myeloma and malignant plasma cell neoplasms
  C90.0 Multiple myeloma
  C90.00 Multiple myeloma not having achieved remission
  C90.01 Multiple myeloma in remission
  C90.02 Multiple myeloma in relapse
Generic (brand) name HCPCS code—code description FDA approved for multiple myeloma Compendia off-label uses for multiple myeloma Possible CPT® administration codes
arsenic trioxide (Trisenox) J9017 – Injection, arsenic trioxide, 1 mg   96413, 96415
bendamustine (Treanda) J9033 – Injection, bendamustine hydrochloride, 1 mg   96413
betamethasone acetate and sodium phosphate (Celestone Soluspan) J0702 – Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg   11900, 11901, 20600, 20605, 20610, 96372
bortezomib (Velcade) J9041 – Injection, bortezomib, 0.1 mg   96409
busulfan (Busulfex) J0594 – Injection, busulfan, 1 mg   96413, 96415
busulfan (Myleran) J8510 – Busulfan, oral, 2 mg   N/A
carfilzomib (Kyprolis) J9047 – Injection, carfilzomib, 1 mg   96409
carmustine (BiCNU) J9050 – Injection, carmustine, 100 mg   96413, 96415
cisplatin (Platinol AQ) J9060 – Injection, cisplatin, powder or solution, per 10 mg   96409, 96413, 96415
cortisone acetate (Cortone) J8499* – Prescription drug, oral, nonchemotherapeutic, not otherwise specified   N/A
cyclophosphamide (Cytoxan) J8530 – Cyclophosphamide, oral, 25 mg   N/A
cyclophosphamide (Cytoxan) J9070 – Cyclophosphamide, 100 mg   96409, 96413, 96415
daratumumab (Darzalex) J9145 – Injection, daratumumab, 10 mg   96413, 96415
dexamethasone (Decadron) J8540 – Dexamethasone, oral, 0.25 mg   N/A
dexamethasone (Decadron) J1100 – Injection, dexamethasone sodium phosphate, 1 mg   11900, 11901, 20600, 20605, 20610, 96372, 96374
doxorubicin HCl (Adriamycin) J9000 – Injection, doxorubicin hydrochloride, 10 mg   96409
doxorubicin HCl liposomal (Doxil) Q2050 – Injection, doxorubicin hydrochloride, liposomal, not otherwise specified, 10 mg   96413
elotuzumab (Empliciti) J9176 – Injection, elotuzumab, 1 mg   96413, 96415
epirubicin (Ellence) J9178 – Injection, epirubicin hydrochloride, 2 mg   96409, 96413
epoetin alfa (Epogen, Procrit) J0885 – Injection, epoetin alfa
(for non-ESRD use), 1000 units
  96372, 96374
epoetin alfa (Epogen, Procrit) Q4081 – Injection, epoetin alfa, 100 units (for ESRD on dialysis)   96372, 96374
etoposide (Vepesid) J8560 – Etoposide, oral, 50 mg   N/A
etoposide (Etopophos, Toposar) J9181 – Injection, etoposide, 10 mg   96413, 96415
hydrocortisone (Solu-Cortef) J1720 – Injection, hydrocortisone sodium succinate, up to 100 mg   96365, 96366, 96372, 96374
hydrocortisone (Cortef) J8499* – Prescription drug, oral, nonchemotherapeutic, not otherwise specified   N/A
ifosfamide (Ifex) J9208 – Injection, ifosfamide, 1 gram   96413, 96415
immune globulin (Bivigam) J1556 – Injection, immune globulin (Bivigam), 500 mg   96365, 96366
immune globulin (Carimune NF, Gammagard S/D) J1566 – Injection, immune globulin, intravenous, lyophilized (eg, powder), not otherwise specified, 500 mg   96365, 96366
immune globulin (Flebogamma DIF) J1572 – Injection, immune globulin (Flebogamma/Flebogamma DIF), intravenous, non-lyophilized (eg, liquid), 500 mg   96365, 96366
immune globulin (Octagam) J1568 – Injection, immune globulin (Octagam), intravenous, non-lyophilized (eg, liquid), 500 mg   96365, 96366
immune globulin (Privigen) J1459 – Injection, immune globulin (Privigen), intravenous, non-lyophilized (eg, liquid), 500 mg   96365, 96366
immune globulin (Gammaplex) J1557 – Injection, immune globulin (Gammaplex), intravenous, non-lyophilized (eg, liquid), 500 mg   96365, 96366, 96369, 96370
immune globulin (Gammagard) J1569 – Injection, immune globulin (Gammagard liquid), non-lyophilized (eg, liquid), 500 mg   96365, 96366, 96369, 96370
immune globulin (Gammaked, Gamunex-C) J1561 – Injection, immune globulin (Gamunex-C/Gammaked), non-lyophilized (eg, liquid), 500 mg   96365, 96366, 96369, 96370
interferon alfa-2b (Intron-A) J9214 – Injection, interferon, alfa-2b, recombinant, 1 million units   96372, 96401
ixazomib (Ninlaro) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
ixazomib (Ninlaro) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
lenalidomide (Revlimid) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
lenalidomide (Revlimid) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
lomustine (CeeNu) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
lomustine (CeeNu) S0178 – Lomustine, oral, 10 mg   N/A
melphalan (Alkeran) J8600 – Melphalan, oral, 2 mg   N/A
melphalan (Alkeran) J9245 – Injection, melphalan hydrochloride, 50 mg   96409, 96413
methylprednisolone (Medrol) J7509 – Methylprednisolone, oral, per 4 mg   N/A
methylprednisolone (Depo-Medrol) J1020 – Injection, methylprednisolone acetate, 20 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone (Depo-Medrol) J1030 – Injection, methylprednisolone acetate, 40 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone (Depo-Medrol) J1040 – Injection, methylprednisolone acetate, 80 mg   11900, 11901, 20600, 20605, 20610, 96372
methylprednisolone (Solu-Medrol) J2930 – Injection, methylprednisolone sodium succinate, up to 125 mg   96365, 96366, 96372, 96374
paclitaxel (Taxol) J9267 – Injection, paclitaxel, 1 mg   96413, 96415
panobinostat (Farydak) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
panobinostat (Farydak) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
peginterferon alfa-2b (Peg-Intron) J3590* – Unclassified biologics   96372
peginterferon alfa-2b (Peg-Intron) S0148 – Injection, pegylated interferon alfa-2b, 10 mcg   96372
pomalidomide (Pomalyst) C9399* – Unclassified drugs or biologicals (Hospital outpatient use only)   N/A
pomalidomide (Pomalyst) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
prednisolone (eg, Millipred, Prelone) J7510 – Prednisolone, oral, per 5 mg   N/A
prednisone (eg, Deltasone, Orasone) J7506 – Prednisone, oral, per 5 mg   N/A
procarbazine (Matulane) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
procarbazine (Matulane) S0182 – Procarbazine hydrochloride, oral, 50 mg   N/A
teniposide (Vumon) Q2017 – Injection, teniposide, 50 mg   96413, 96415
thalidomide (Thalomid) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
topotecan (Hycamtin) J9351 – Injection, topotecan, 0.1 mg   96413
vinCRIStine (Vincasar PFS) J9370 – Vincristine sulfate, 1 mg   96409
vorinostat (Zolinza) J8999* – Prescription drug, oral, chemotherapeutic, not otherwise specified   N/A
*When billing a nonclassified medication using a CMS 1500 claim form you must include both the HCPCS code (eg, J8999 for Ninlaro) 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 payer regarding correct placement of Medication Information in Item 19 or 24A shaded area.
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)
ESRD indicates end-stage renal disease; HCPCS, Healthcare Common Procedure Coding System.
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