About this policy
Due to the current shortage of Bacillus Calmette-Guérin (BCG) for intravesical instillation it may be necessary to maintain ongoing treatment for bladder cancer with this product at less than the Food and Drug Administration (FDA) label dose of 81 mg (1 vial) per instillation. In response to this situation, Centers for Medicare and Medicaid Services (CMS) has created a new HCPCS code by which to report BCG which will allow for reporting of doses less than 1 vial per instillation. HCPCS code J9030 BCG live intravesical instillation, 1 mg becomes effective 7/1/2019 and replaces HCPCS code J9031 BCG intravesical per instillation . HCPCS code J9031 BCG intravesical per instillation will no longer be payable by Medicare as of 7/1/2019. HCPCS code J9030 should be reported with the number of units corresponding to the units being equal to the number of milligrams actually instilled per treatment, as the unit equals 1 mg for the new code. For updates on the current shortage of BCG live intravesical: https://www.ashp.org/Drug-Shortages/Current-Shortages
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| J9030 | HCPCS | Covered |