Article Detail - JF Part A
Pegfilgrastim (Neulasta) J2505 and Q5122 - (Injection, pegfilgrastim-apgf, biosimilar, (Nyvepria))Article A55447 Retirement - Effective November 1, 2023
This coverage article has been retired under contractor numbers: 02101 (AK), 02201 (ID), 02301 (OR), 02401 (WA), 03101 (AZ), 03201 (MT), 03301 (ND), 03401 (SD), 03501 (UT), and 03601 (WY).
Medicare Coverage Database (MCD) Number: A55447
Effective Date: November 1, 2023
Rationale: Coverage articles may be retired due to lack of evidence of current problems or CMS may have issued guidance regarding national coverage. The Noridian guidance in the retired article may still be helpful in assessing medical necessity. Where providers have adjusted their billing and coding practices to correspond to the guidance in a coverage article, they will want to be very careful in departing from these practices just because the article is retired. Provider offices remain responsible for correct performance, coding, billing, and medical necessity under Medicare. This responsibility for correct claims submission is unchanged whether or not there is a coverage article in place.
Visit the Retired LCDs webpage to access the retired LCDs.