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).