J9161 HCPCS code: Injection, denileukin diftitox-cxdl, 1 mcg
J9161 is the HCPCS Level II code for injection, denileukin diftitox-cxdl, 1 mcg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1500 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2025-04-01 |
| Last action effective | 2025-04-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1500 | CMS Policy |
| outpatient hospital claims | 1500 | CMS Policy |
| practitioner claims | 1500 | CMS Policy |
What changed for J9161
- April 2025: Code appears in this HCPCS release
- 2025-04-01: J9161 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J9161?
J9161 is the HCPCS Level II code for injection, denileukin diftitox-cxdl, 1 mcg. Short descriptor: "Inj denileuk difti-cxdl 1mcg".
Does Medicare cover J9161?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9161 can be billed per day?
1500 on DME suppliers; 1500 on outpatient hospital claims; 1500 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9119 — Injection, cemiplimab-rwlc, 1 mg
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9155 — Injection, degarelix, 1 mg
- J9160 — Injection, denileukin diftitox, 300 micrograms
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Next steps
- Run a reimbursement report for a device billed under J9161
- Watch J9161 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9161
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.