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Immunosuppressive Drugs - Policy Article
Article A52474 · 14 versions, 2015 to today · last changed 2025-01-01 (R13)
Version 20 of Article A52474: in force by CMS's dates 2017-01-01 to 2018-12-31. The policy text on this page comes from this archived version.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
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Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.
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Version history, Article A52474
CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.
Revision history, every version
CMS's own change log, quoted, 13 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.
R13 · 2025-01-01 · v40
Revision Effective Date: 01/01/2025 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: "Antibiotics, hypertensives, and other drugs that are not directly related to rejection are not covered." Added: "or a 90-day" to the sentence "One unit of service of supply fee code Q0511 is covered for the first covered immunosuppressive drug that is dispensed in a 30-day or 90-day period." Added: "or a 90-day” to the sentence "If covered drugs are dispensed by more than one pharmacy during a 30-day or 90-day period, one unit of Q0511 is covered for each pharmacy." Added: "or 90-day” to the sentence "One unit of service of supply fee code Q0512 is covered for each subsequent covered immunosuppressive drug that is dispensed in that 30-day or 90-day period (See exception below when Q0510 is covered in place of Q0511 or Q0512.)" Added: "or 90" to the sentence "If more than one unit of service of code Q0511 is billed per 30 or 90 days by a single pharmacy, the excess units of service will be denied as incorrect coding." 09/18/2025: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R12 · 2025-01-01 · v37
Revision Effective Date: 01/01/2025 MODIFIERS: Added: JW and JZ modifier guidelines 05/22/2025: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R11 · 2023-01-01 · v32
Revision Effective Date: 01/01/2023 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: “PA” to “pancreas transplant alone” 05/04/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R10 · 2023-01-01 · v30
Revision Effective Date: 01/01/2023 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Medicare entitlement statement to include coverage beyond 36 months for beneficiaries eligible and enrolled in the Part B immunosuppressive drug benefit (PBID) 11/17/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R9 · 2020-01-01 · v28
Revision Effective Date: 01/01/2020: REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217): Removed: “The link will be located here once it is available.” Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list 04/14/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R8 · 2020-01-01 · v26
Revision Effective Date: 01/01/2020: REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217): Added: Section and related information based on Final Rule 1713 MODIFIERS: Revised: “ordering physician” to “treating practitioner” ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY: Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity” ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY: Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity” 02/06/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R7 · 2019-01-01 · v22
Revision Effective Date: 01/01/2019 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Criterion V to allow drugs to be dispensed two days prior to discharge to the home Removed: Statement regarding KX modifier CODING INFORMATION: Removed: Bill type code inadvertently added 02/28/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R6 · 2017-01-01 · v20
Revision Effective Date: 01/01/2017 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES Revised: Corrected typo inbeneficiary and outbeneficiary to inpatient and outpatient 04/05/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R5 · 2017-01-01 · v13
Revision Effective Date: 01/01/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: Continued Medical Need and Continued Use sections (clerical error)
R4 · 2017-01-01 · v11
Revision Effective Date: 01/01/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: Modifiers requirements RELATED LOCAL COVERAGE DOCUMENTS: Added: LCD-related Standard Documentation Requirements Language Article
R3 · 2016-07-01 · v8
Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.
R2 · 2016-01-01 · v7
Revision Effective Dates: 01/01/2016 CODING GUIDELINES: Removed: J7506 from billing example, replaced with J7510
R1 · 2015-10-01 · v4
Revision Effective Date: 10/01/2015 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: ICD-9 diagnosis references CODING GUIDELINES: Added: J7599 billing guidelines
Receipts for auditors
Version 20 of Article A52474, shown on this page: in force by CMS's dates 2017-01-01 to 2018-12-31. Archived 2026-09-26. CMS's copy · Our archived file. 3 of 3 sections are proven word-identical to the archived file.
Every archived version of Article A52474 (14 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| Article A52474 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 4 | 2015-10-01 to 2015-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 7 | 2016-01-01 to 2016-06-30 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 8 | 2016-07-01 to 2016-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 11 | 2017-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 13 | 2017-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 20 shown | 2017-01-01 to 2018-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 22 | 2019-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 26 | 2020-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 28 | 2020-01-01 to 2022-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 30 | 2023-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 32 | 2023-01-01 to 2024-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52474 | version 37 | 2025-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A52474 | version 40 | 2025-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
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