Injection of Hospira-brand docetaxel chemotherapy, billed per milligram

This code represents the Hospira-manufactured formulation of docetaxel, a taxane-class antineoplastic agent that inhibits microtubule depolymerization, administered via injection at a per-milligram billing unit. It is designated as not therapeutically equivalent to the reference docetaxel code (J9171), reflecting a payer-recognized distinction between manufacturer-specific formulations. This distinction is clinically relevant for reimbursement purposes when the Hospira product is specifically dispensed.

Use this code when the Hospira-labeled docetaxel product is administered in an outpatient infusion, clinic, or physician office setting and the claim requires manufacturer-specific identification. Common oncologic indications include breast cancer, non-small cell lung cancer, prostate cancer, gastric adenocarcinoma, and head and neck cancer. Supporting documentation should include the drug order or medication administration record specifying the Hospira manufacturer, the total milligrams administered, and the clinical indication.

• Units matter: Bill in 1 mg increments; verify the total administered dose against the order and waste documentation to ensure accurate unit reporting — undercoding or overcoding milligrams is a common audit trigger.
• Do not interchange with J9171: These codes are explicitly designated as non-therapeutically equivalent for billing purposes; using J9171 when Hospira-branded docetaxel is dispensed may result in claim denial or compliance risk — payer policies on brand-specific chemotherapy codes vary, so verify coverage before submission.
• NDC reporting: Many payers, including Medicare, require the National Drug Code (NDC) on the claim line; confirm the NDC corresponds to the Hospira product to substantiate use of this code over the generic/alternate formulation code.