Rituxan (rituximab) is heavily utilized in oncology and rheumatology. Billed under J9312 ↗, claims require accurate chemotherapy infusion coding and 10mg unit divisions.
Rituxan Unit Calculation (J9312)
The HCPCS code description for J9312 ↗ is "Injection, rituximab, 10 mg".
If a patient receives a standard 700 mg infusion, divide by 10. You will bill exactly 70 units.
| Drug | Code | Administered Dosage | Billing Units |
|---|---|---|---|
| Rituxan | J9312 | 700 mg | 70 |
Medical Necessity Linkage
Rituxan requires strict linkage to an approved LCD/NCD diagnosis, such as:
- C82.90 ↗ - Follicular lymphoma, unspecified
- M05.70 ↗ - Rheumatoid arthritis with rheumatoid factor
Administration and NCCI Rules
Because Rituxan is a monoclonal antibody, bill it using chemotherapy administration codes (96413 ↗ for the first hour, 96415 ↗ for each additional hour).