• Standard dose: 75 mg mitomycin (56 mL product)
• Schedule: Once weekly × 6 weeks
• Preparation:
  1. Prepared on-site (under chilled conditions) by your pharmacy/clinic staff, or
  2. Prepared by a contracted UroGen partner pharmacy and delivered to your facility chilled for administration.
• Retention time: Prolonged (5–24 hours)

• 51720 – Bladder instillation of anticarcinogenic agent (including retention time)

• J9999 – Antineoplastic drugs, not otherwise classified (recommended for Zusduri)

Some payers may require:

• J3490 – Unclassified drugs
• J3590 – Unclassified biologics

Box 19:
Use Box 19 to document the NDC number, drug name, route of administration, and dosage given. If billing with a miscellaneous code, record any drug wastage here.

Example: A patient receives 75 mg from an 80 mg vial. The remaining 5 mg should be documented as wastage. Box 19 could be written like: 72493010603 ZUSDURI Instillation ME75 ME5JW

Important: Do not use J9280 (Mitomycin, 5 mg) for Zusduri.

Pair C67.x site-specific malignant neoplasm codes with treatment/encounter Z-codes as appropriate. Code to the specific location when known. Documentation should reflect stage, grade, and risk category.

• C67.0 – Malignant neoplasm of trigone of bladder
• C67.1 – Malignant neoplasm of dome of bladder
• C67.2 – Malignant neoplasm of lateral wall of bladder
• C67.3 – Malignant neoplasm of anterior wall of bladder
• C67.4 – Malignant neoplasm of posterior wall of bladder
• C67.5 – Malignant neoplasm of bladder neck
• C67.6 – Malignant neoplasm of ureteric orifice
• C67.7 – Malignant neoplasm of urachus
• C67.8 – Malignant neoplasm of overlapping sites of bladder
• C67.9 – Malignant neoplasm of bladder, unspecified

• Z51.11 – Encounter for antineoplastic chemotherapy (e.g., mitomycin, gemcitabine)
  (List as principal diagnosis)
• Z51.12 – Encounter for antineoplastic immunotherapy (e.g., BCG)
  (List as principal diagnosis)
• Z85.51 – Personal history of malignant neoplasm of bladder (surveillance when no active disease)

Note: ICD-10-CM does not capture grade/stage—keep these in documentation.

• New Drug: Until ASP is available (~2 quarters), reimbursed at 103% of WAC
• Medicare Part B: Paid at 106% of ASP once established

• Bladder cancer type, stage, risk category, tumor location
• Amount instilled, amount discarded (modifier -JW)
• Rationale for choosing Zusduri

• Appeals & Prior Authorization: Often required; expect record requests
• Coverage: Typically follows FDA-approved indications; confirm with payer before administration

• Zusduri provides prolonged bladder drug exposure for eligible recurrent, low-grade, intermediate-risk NMIBC patients
• Use CPT® 51720 for instillation and J9999 (or payer-specific unlisted code) for the drug
• Detailed documentation is critical for coverage and payment
• Expect WAC-based reimbursement until ASP is established