HCPCS Service Coding for Oral Cancer Drugs (Rev. 1, 10-01-03)

by  Jared Staheli
July 8th, 2015

The following codes may be used for drugs other than Prodrugs, when covered:

Generic/Chemical Name How Supplied HCPCS
Busulfan 2 mg/ORAL J8510
Capecitabine 150mg/ORAL J8520
Capecitabine 500mg/ORAL J8521
Methotrexate 2.5 mg/ORAL J8610
Cyclophosphamide * 25 mg/ORAL J8530

Cyclophosphamide *

(Treat 50 mg. as 2 units

50 mg/ORAL J8530
Etoposide 50 mg/ORAL J8560
Melphalan 2 mg/ORAL J8600
Prescription Drug chemotherapeutic NOC ORAL J8999

Each tablet or capsule is equal to one unit, except for 50 mg./ORAL of cyclophosphamide (J8530), which is shown as 2 units. The 25m and 50 mg share the same code.

NOTE: HIPAA requires that drug claims submitted to DMERCs be identified by NDC.

References:

HCPCS Service Coding for Oral Cancer Drugs (Rev. 1, 10-01-03). (2015, July 8). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/hcpcs-service-coding-for-oral-cancer-drugs-rev-1-10-01-03-27115.html

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