Chemotherapy Administration - R17 and R18

This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, NMI) and 01312 (NV).

Effective Date: January 1, 2019
Summary of Changes:

  • Added the following J codes to the Infusions Chemotherapy section
    • J0640 - leucovorin calcium to have IV chemo admin codes payable when given with 5-Fluoracil
    • J2783 - rasburicase (Elitek®)
    • J2820 - sargramostim (Leukine®)
    • J9999 - (OPPS:C9399) for Elzonris™
    • Q5109 - infliximab-qbtx (Ixifi™)
  • Added J2820 sargramostim (Leukine®) as payable with 96401 if given for the treatment of cancer
  • Added and deleted the following codes to the list of drugs payable with an external portable pump (G0498) as indicated in each Product Information sheet
  • Added:
    • J9065 - cladribine,
    • J9041 - bortezomib
    • J9267 - Paclitaxel to be payable per the Product Information sheet
  • Deleted:
    • J9371 - vincristine sulfate liposome (Oncovin, Vincasar PFS)
    • Adrucil® listed with J9190 since it had been discontinued

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Last Updated Feb 14, 2019