HCPCS code J9030 BCG live intravesical instillation, 1 mg becomes effective 7/1/2019 and replaces HCPCS code J9031 BCG intravesical per instillation.
Is BCG treatment a form of chemotherapy? No. Although intravesical immunotherapy and intravesical chemotherapy are given the same way, these two treatments use different types of drugs. While chemotherapy drugs attack cancer cells directly, immunotherapy drugs harness the power of your immune system.
Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer. It's used to help keep the cancer from growing and to help keep it from coming back. BCG is a germ that's related to the one that causes tuberculosis (TB), but it doesn't usually cause serious disease.
BCG has a cumulative effect, so increased toxicity is to be expected during long-term administration. BCG toxicity is primarily a response of the cell-mediated immune system, and transient local or systemic infection appears to be important.
What is BCG? Maintenance therapy for bladder cancer typically involves a type of treatment called Bacillus Calmette-Guerin (BCG) intravesical immunotherapy. BCG is a type of bacteria that helps the immune system to destroy cancer cells located in the bladder lining.
BCG appears to be superior to intravesical chemotherapy with regard to the rate of recurrence, the response rate and the percentage of patients remaining tumor-free; however BCG is more toxic than chemotherapy (5–11).
For most people with high-risk non-muscle invasive bladder cancer, the initial course of six BCG treatments is followed by what is known as maintenance BCG. Maintenance treatment with BCG reduces the risk of the disease coming back or spreading.
BCG is in a liquid solution that is put into the bladder with a catheter. The person then holds the solution in the bladder for two hours before urinating. The treatment is usually given once per week for six weeks, starting approximately two to three weeks after the last TURBT.
It is nearly 40 years since Bacillus Calmette–Guérin (BCG) was first used as an immunotherapy to treat superficial bladder cancer. Despite its limitations, to date it has not been surpassed by any other treatment.
BCG is typically used for noninvasive and minimally invasive bladder cancers, and it may be covered by Medicare if it's deemed medically necessary by your doctor.
In multivariable sensitivity analyses, full-dose and one-third dose maintenance BCG was cost-effective in 17% and 39% of microsimulations, respectively. However, maintenance BCG became cost-effective if it decreased the five-year bladder cancer recurrence rate by 34.8% relative to surveillance alone.
Because BCG is a live attenuated organism, it can cause an acute disseminated tuberculosis-like illness if it enters the bloodstream (BCG sepsis), possibly resulting in death. Reports have described BCG vaccine organisms identified on vascular grafts in patients who have died following BCG vaccine sepsis.