Oral Anticancer Drugs and Oral Antiemetic Drugs

The Standard Written Order (SWO) requirements are in effect for dates of service January 1, 2020 and after.
Refer to the SWO page for the elements needed in this streamlined order.

Oral anticancer drugs are covered under the oral anticancer drug benefit [Social Security Act §1861(s)(2)(Q)]. Oral Antiemetic Drugs are covered under the Oral Antiemetic Drug benefit (Social Security Act §1861(s)(2)(T)).

Coverage

Documentation

Fees

Tips

Topic Details
New ICD 10-Codes NCD110.18 Aprepitant for Chemo-Induced Emesis has been updated. Added ICD-10 codes D04.111, D04.112, D04.121, and D04.122. See CMS Medicare Learning Network (MLN) Matters (MM)10859 for details.

 

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Last Updated Jan 10, 2020

The below are topic specific articles which have been published to "Latest Updates" and sent out in Noridian emails within the past two years. Exclusions to this include time sensitive related announcements such as: Noridian and CMS educational events, Ask-the-Contractor Teleconferences and claims processing downtime.

NDC for Capecitabine (Xeloda®) 500 mg. Dosage Form - European Formulation Blister Pack DMD   May 26, 2017
Billing for Capecitabine (Xeloda®) 500 mg Dosage Form - European Formulation Blister Pack DMD   May 26, 2017
RETIRED - Oral Anti-Cancer Drugs - Coding and Billing Change DMD   May 25, 2017
RETIRED - Billing Reminder - Units of Service for Oral Anticancer Drugs (OACD) DMD   May 25, 2017
RETIRED - Oral Anticancer Drugs - Covered Diagnoses DMD   May 11, 2017
Oral Anti-Emetic Drugs - Coverage Reminder DMD   May 11, 2017
New National Drug Codes (NDCs) for Etoposide DMD   May 11, 2017
New National Drug Code (NDC) Numbers For Methotrexate DMD   May 11, 2017