Oral anti-cancer drugs (OACD) must be billed to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) with the National Drug Code (NDC) that matches the product and HCPCS code dispensed. The following information pertains to the billing of oral Capecitabine covered under the OACD Local Coverage Determination (LCD L33826).

HCPCS code J8522 (Capecitabine) was implemented on January 1, 2025, effective for dates of service (DOS) on or after October 1, 2025, and was subsequently cross walked to the appropriate NDC. Claims for Capecitabine submitted to the DME MAC must be billed using the appropriate NDC.

Suppliers are reminded not to bill Capecitabine using HCPCS J8522 or J8999. Suppliers bill with the appropriate NDC. Refer to LCD L33826 and Policy Article A52479 for more information.