The provider should enter the appropriate number of units, based on the HCPCS definition and dose administered, in form locator 46 of the UB-04 claim form.
| Example Dose | Number of Units |
|---|---|
| Patient receives 200 mg of cyclophosphamide (brand names: Cytoxan, Neosar). | The provider should bill one unit of J9080 (cyclophosphamide, 200 mg). |
| Patient receives 1.5 g of cyclophosphamide. | When a fraction of a unit is administered, the provider should bill for the next higher whole unit. In this case, bill one unit of J9092 (cyclophosphamide, 2 g). |
| Patient receives 90 mg of pamidronate disodium (brand name: Aredia). | The provider should bill three units of J2430 (injection, pamidronate disodium, per 30 mg). |
| Patient receives trastuzumab (brand name: Herceptin). | The maintenance dose of trastuzumab is based on the weight of the patient at a ratio of 2 mg per 1 kg. A patient weighing 50 kg would therefore be given 100 mg. In this case, the provider should bill 10 units of J9355 (trastuzumab, 10 mg). |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |