J9999 should be used only if the specific J code for an agent does not exist. When possible, avoid using J9999 when billing for routine chemotherapy drugs. This code does not provide sufficient information for HMSA to determine the appropriate payment, resulting in delayed claims processing.
Whenever J9999 is used, enter the corresponding NDC information in form locator 43. This allows HMSA to accurately identify the drug and the strength administered. In form locator 80, enter the specific dosage administered (e.g., number of milliliters) rather than the number of packages, vials, etc.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 |