PRS CodeMatrix©: JELMYTO®
Download the JELMYTO® CodeMatrix©
Access a practical PRS reimbursement tool designed to help urology practices understand coding, documentation, billing, and payer considerations related to JELMYTO® for upper tract urothelial cancer.
Current Version: Q3 2026
Download JELMYTO® CodeMatrix©What’s Included
- Physician office coding guidance for retrograde and antegrade approaches
- CPT and HCPCS coding considerations, including J9281 and JW modifier use
- ICD-10-CM diagnosis coding for renal pelvis and ureter malignancies
- Facility coding considerations for ASC and HOPD settings
- Documentation guidance for amount administered, wastage, route, and imaging
- Billing and payer considerations, including prior authorization and site-of-service requirements
Designed For
- Urologists
- Advanced Practice Providers
- Billing and coding teams
- Practice administrators
- Revenue cycle leadership
- Facility billing teams
PRS Perspective
JELMYTO® billing depends on the route of administration, site of care, payer rules, documentation of administered and wasted drug amounts, and the appropriate use of procedure, drug, diagnosis, and modifier codes. PRS CodeMatrix© tools are designed to help practices evaluate, document, code, bill, and operationalize complex urology technologies and services with greater reimbursement clarity.
