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    HCPCS Details

    HCPC J9204
    Short Description Inj mogamulizumab-kpkc, 1 mg
    Long Description Injection, mogamulizumab-kpkc, 1 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1D
    Action code N
    Type of service 1
    Effective date 2019-10-01
    Date Added 2019-10-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    42747076101 J9204 Inj mogamulizumab-kpkc, 1 mg POTELIGEO KYOWA KIRIN, INC. 1 MG 5 1 20 20
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 1 MG
    HCPCS/CPT Billing Units 1
    Total doses ordered
    Billing Units 1

    Drug Details

    • Mogamulizumab-kpkc injection is used to treat mycosis fungoides and Sézary syndrome, two types of cutaneous T-cell lymphoma ([CTCL], a group of cancers of the immune system that first appear as skin rashes), in adults whose disease has not improved, has gotten worse, or has come back after taking other medications. Mogamulizumab-kpkc injection is in a class of medications called monoclonal antibodies. It works by activating the immune system to attack cancer cells.