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Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article
Article A52480 · 44 versions, 2015 to today · last changed 2026-10-01 (R23)
Version 67 of Article A52480: in force by CMS's dates 2022-10-01 to 2022-09-30. The policy text on this page comes from this archived version.
DME MAC jurisdictions
JA · Noridian 16013
CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT
JB · CGS 17013
IL, IN, KY, MI, MN, OH, WI
JC · CGS 18003
AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, WV
JD · Noridian 19003
AK, AS, AZ, CA, GU, HI, ID, IA, KS, MO, MT, NE, NV, ND, MP, OR, SD, UT, WA, WY
source
CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.
Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.
Full verbatim text serves to customers · Customer? Log in
Version history, Article A52480
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 Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask.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.
v22015-10-01, superseded same dayv22015-10-01, superseded same dayv52015-10-01, superseded same dayv52015-10-01, superseded same dayv72015-10-01, superseded same dayv72015-10-01, superseded same dayv92015-10-01, superseded same dayv92015-10-01, superseded same dayv112015-10-01, superseded same dayv112015-10-01 to 2015-12-31v152016-01-01, superseded same dayv152016-01-01 to 2016-06-30v162016-07-01, superseded same dayv162016-07-01, superseded same dayv192016-07-01, superseded same dayv192016-07-01 to 2016-09-30v282016-10-01, superseded same dayv282016-10-01 to 2016-12-31v322017-01-01, superseded same dayv322017-01-01 to 2017-09-30v392017-10-01, superseded same dayv392017-10-01 to 2018-09-30v452018-10-01, superseded same dayv452018-10-01 to 2018-12-31v482019-01-01, superseded same dayv482019-01-01 to 2019-12-31v512020-01-01, superseded same dayv512020-01-01, superseded same dayv542020-01-01, superseded same dayv542020-01-01 to 2021-09-30v582021-10-01, superseded same dayv582021-10-01 to 2022-03-31v612022-04-01, superseded same dayv612022-04-01 to 2022-09-30v672022-10-01, superseded same dayv672022-10-01 to 2023-09-30v732023-10-01, superseded same dayv732023-10-01 to 2024-09-30v802024-10-01, superseded same dayv802024-10-01 to 2024-12-31v832025-01-01 to 2025-09-30v862025-10-01 to 2025-12-31v902026-01-01 to 2026-09-30v932026-10-01 to today
Revision history, every version
CMS's own change log, quoted, 42 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.
R23 · 2026-10-01 · v93
Revision Effective Date: 10/01/2026 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Added: ICD-10-CM codes C78.31, C78.32, and C79.83 to Group 1 Codes, due to ICD-10-CM code updates 10/01/2026: 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.
R22 · 2026-01-01 · v90
Revision Effective Date: 01/01/2026 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: HCPCS codes J8650 and Q0174 from coverage direction CODING GUIDELINES: Removed: HCPCS codes J8650 and Q0174 01/08/2026: 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.
R21 · 2025-10-01 · v86
Revision Effective Date: 10/01/2025 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Added: ICD-10-CM codes C50.A0, C50.A1 and C50.A2 to Group 1 Codes, due to ICD-10-CM code updates 10/09/2025: 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.
R20 · 2025-01-01 · v83
Revision Effective Date: 01/01/2025 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Q0155 to the list of oral antiemetic drugs covered when criteria met CODING GUIDELINES: Added: Q0155 to the list of oral antiemetic drugs that may be billed Added: Q0155 to the instructions regarding the quantity of drugs billed must not exceed the 24 or 48 hours of therapy indicated 01/16/2025: 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.
R19 · 2024-10-01 · v80
Revision Effective Date: 10/01/2024 I CD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM code C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9 from Group 1 Codes, due to ICD-10-CM code updates Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 1 Codes, due to ICD-10-CM code updates 09/12/2024: 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.
R19 · 2024-10-01 · v80
Revision Effective Date: 10/01/2024 I CD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM code C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9 from Group 1 Codes, due to ICD-10-CM code updates Added: ICD-10-CM codes C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A, C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, C86.00, C86.01, C86.10, C86.11, C86.20, C86.21, C86.30, C86.31, C86.40, C86.41, C86.50, C86.51, C86.60, C86.61, C88.00, C88.01, C88.20, C88.21, C88.30, C88.31, C88.40, C88.41, C88.80, C88.81, C88.90, C88.91 to Group 1 Codes, due to ICD-10-CM code updates 09/12/2024: 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.
R18 · 2023-10-01 · v73
Revision Effective Date: 10/01/2023 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM code D48.1 from Group 1 Codes due to ICD-10-CM code updates Added: ICD-10-CM codes D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, D48.19 to Group 1 Codes due to ICD-10-CM code updates 09/21/2023: 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.
R18 · 2023-10-01 · v73
Revision Effective Date: 10/01/2023 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM code D48.1 from Group 1 Codes due to ICD-10-CM code updates Added: ICD-10-CM codes D48.110, D48.111, D48.112, D48.113, D48.114, D48.115, D48.116, D48.117, D48.118, D48.119, D48.19 to Group 1 Codes due to ICD-10-CM code updates 09/21/2023: 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.
R17 · 2022-10-01 · v67
Revision Effective Date: 10/01/2022 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Revised: ICD-10-CM code descriptor for C84.41, C84.42, C84.43, C84.44, C84.45, C84.46, C84.47, C84.48, C84.49, C94.6 in Group 1 Codes due to ICD-10-CM code updates 09/22/2022: 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.
R17 · 2022-10-01 · v67
Revision Effective Date: 10/01/2022 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Revised: ICD-10-CM code descriptor for C84.41, C84.42, C84.43, C84.44, C84.45, C84.46, C84.47, C84.48, C84.49, C94.6 in Group 1 Codes due to ICD-10-CM code updates 09/22/2022: 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.
R16 · 2022-04-01 · v61
Revision Effective Date: 04/01/2022 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 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM D49.4, D49.511, D49.512, D49.6, D49.89 from Group 1 due to NCD 110.18 update 03/31/2022: 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.
R16 · 2022-04-01 · v61
Revision Effective Date: 04/01/2022 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 ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Removed: ICD-10-CM D49.4, D49.511, D49.512, D49.6, D49.89 from Group 1 due to NCD 110.18 update 03/31/2022: 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.
R15 · 2021-10-01 · v58
Revision Effective Date: 10/01/2021 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: “multiple codes” after “netupitant/palonosetron” and replaced with J8655 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: References of “Q0181” and “depending on date of service” after palonosetron and netupitant/palonosetron Added: Instructions for billing Q0181 CODING GUIDELINES: Added: Directions for billing rolapitant based on multiple codes for the appropriate date of service ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Added: ICD-10-CM C56.3, C79.63 and C84.7A to Group 1 due to annual ICD-10-CM code updates 10/07/2021: 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.
R15 · 2021-10-01 · v58
Revision Effective Date: 10/01/2021 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: “multiple codes” after “netupitant/palonosetron” and replaced with J8655 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: References of “Q0181” and “depending on date of service” after palonosetron and netupitant/palonosetron Added: Instructions for billing Q0181 CODING GUIDELINES: Added: Directions for billing rolapitant based on multiple codes for the appropriate date of service ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY: Added: ICD-10-CM C56.3, C79.63 and C84.7A to Group 1 due to annual ICD-10-CM code updates 10/07/2021: 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.
R14 · 2020-01-01 · v54
Revision Effective Date: 01/01/2020 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: HCPCS Codes Q0981 and Q9978 which are no longer valid for billing CODING GUIDELINES: Removed: HCPCS Codes Q9978 and Q9981 which are no longer valid for billing 03/11/2021: 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.
R14 · 2020-01-01 · v54
Revision Effective Date: 01/01/2020 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Removed: HCPCS Codes Q0981 and Q9978 which are no longer valid for billing CODING GUIDELINES: Removed: HCPCS Codes Q9978 and Q9981 which are no longer valid for billing 03/11/2021: 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.
R13 · 2020-01-01 · v51
Revision Effective Date: 01/01/2020 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS 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 CODING GUIDELINES: Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS 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” 02/13/2020: 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.
R13 · 2020-01-01 · v51
Revision Effective Date: 01/01/2020 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS 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 CODING GUIDELINES: Revised: Format of HCPCS code references, from code spans to individually-listed HCPCS 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” 02/13/2020: 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.
R12 · 2019-01-01 · v48
Revision Effective Date: 01/01/2019: CODING GUIDELINES: Added: “ORAL” to HCPCS code J8655 code description 02/14/2019: 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.
R12 · 2019-01-01 · v48
Revision Effective Date: 01/01/2019: CODING GUIDELINES: Added: “ORAL” to HCPCS code J8655 code description 02/14/2019: 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.
R11 · 2018-10-01 · v45
Revision Effective Date: 10/01/2018: ICD-10 Codes that are Covered Removed: Non-specific ICD-10 codes no longer valid for submission: C43.11, C43.12, C4A.11, C4A.12, C44.102, C44.109, C44.112, C44.119, C44.122, C44.129, C44.192, C44.199, D03.11, D03.12, D04.11, D04.12 Added: New expanded ICD-10 codes for those removed 09/27/2018: 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.
R11 · 2018-10-01 · v45
Revision Effective Date: 10/01/2018: ICD-10 Codes that are Covered Removed: Non-specific ICD-10 codes no longer valid for submission: C43.11, C43.12, C4A.11, C4A.12, C44.102, C44.109, C44.112, C44.119, C44.122, C44.129, C44.192, C44.199, D03.11, D03.12, D04.11, D04.12 Added: New expanded ICD-10 codes for those removed 09/27/2018: 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.
R10 · 2017-10-01 · v39
Revision Effective Date: 10/01/2017 Covered ICD-10 Codes Added: New ICD-10 codes Deleted: Non-valid ICD-10 C96.2, D47.0 effective 09/30/17 (all other ICD-10 codes deleted effective 10/01/15) 02/01/18: 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.
R10 · 2017-10-01 · v39
Revision Effective Date: 10/01/2017 Covered ICD-10 Codes Added: New ICD-10 codes Deleted: Non-valid ICD-10 C96.2, D47.0 effective 09/30/17 (all other ICD-10 codes deleted effective 10/01/15) 02/01/18: 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.
R9 · 2017-01-01 · v32
Revision Effective Date: 01/01/2017: NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: HCPCS J8670 for billing Rolapitant effective on or after 01/01/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: Billing instructions and Modifiers section CODING GUIDELINES: Added: HCPCS J8670 for billing Rolapitant effective on or after 01/01/2017 RELATED LOCAL COVERAGE DOCUMENTS: Added: The LCD-related Standard Documentation Requirements Language Article
R9 · 2017-01-01 · v32
Revision Effective Date: 01/01/2017: NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: HCPCS J8670 for billing Rolapitant effective on or after 01/01/2017 POLICY SPECIFIC DOCUMENTATION REQUIREMENTS: Added: Billing instructions and Modifiers section CODING GUIDELINES: Added: HCPCS J8670 for billing Rolapitant effective on or after 01/01/2017 RELATED LOCAL COVERAGE DOCUMENTS: Added: The LCD-related Standard Documentation Requirements Language Article
R8 · 2016-10-01 · v28
Revision Effective Date: 10/01/2016 ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY: Added: New ICD-10 codes per Annual ICD-10 Codes Updates Deleted: Non-valid ICD-10 codes per Annual ICD-10 Codes Updates Revised: ICD-10 code descriptions per Annual ICD-10 Codes Updates Deleted: ICD-10 codes per Coding Revisions to National Coverage Determinations (effective 10/01/2015)
R8 · 2016-10-01 · v28
Revision Effective Date: 10/01/2016 ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY: Added: New ICD-10 codes per Annual ICD-10 Codes Updates Deleted: Non-valid ICD-10 codes per Annual ICD-10 Codes Updates Revised: ICD-10 code descriptions per Annual ICD-10 Codes Updates Deleted: ICD-10 codes per Coding Revisions to National Coverage Determinations (effective 10/01/2015)
R7 · 2016-07-01 · v19
Revision Effective Date: 07/01/2016 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Covered 3-drug combination regimen with Q9981 CODING GUIDELINES: Added: HCPCS Q9981 for billing Rolapitant effective on or after 07/01/2016 Added: End date for HCPCS Q0181 Added: HCPCS Q9981 to coding instructions
R7 · 2016-07-01 · v19
Revision Effective Date: 07/01/2016 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Covered 3-drug combination regimen with Q9981 CODING GUIDELINES: Added: HCPCS Q9981 for billing Rolapitant effective on or after 07/01/2016 Added: End date for HCPCS Q0181 Added: HCPCS Q9981 to coding instructions
R6 · 2016-07-01 · v16
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.
R6 · 2016-07-01 · v16
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.
R5 · 2016-01-01 · v15
Revision Effective Date: 01/01/2016 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Covered 3-drug combination regimen CODING GUIDELINES: Added: J8655 Added: End date of 12/31/2015 for Q9978 Added: Q0181 for billing rolapitant effective on or after 09/02/2015
R5 · 2016-01-01 · v15
Revision Effective Date: 01/01/2016 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Revised: Covered 3-drug combination regimen CODING GUIDELINES: Added: J8655 Added: End date of 12/31/2015 for Q9978 Added: Q0181 for billing rolapitant effective on or after 09/02/2015
R1 · 2015-10-01 · v5
Revision Effective Date: 10/31/2014 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: HCPCS Codes J8650, Q0161 – Q0180 to oral antiemetic drug coverage criteria Revised: 3-drug combination regimen - Akynzeo® (netupitant with palonosetron) NK-1/5HT3 antagonist available - effective on and after 10/10/2014 CODING GUIDELINES: Added: Akynzeo® (netupitant with palonosetron) NK-1/5HT3 antagonist available - effective on and after 10/10/2014
R1 · 2015-10-01 · v5
Revision Effective Date: 10/31/2014 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: HCPCS Codes J8650, Q0161 – Q0180 to oral antiemetic drug coverage criteria Revised: 3-drug combination regimen - Akynzeo® (netupitant with palonosetron) NK-1/5HT3 antagonist available - effective on and after 10/10/2014 CODING GUIDELINES: Added: Akynzeo® (netupitant with palonosetron) NK-1/5HT3 antagonist available - effective on and after 10/10/2014
R4 · 2015-07-01 · v11
Revision Effective Date: 07/01/2015 (August Publication) NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Corrected code range listing Corrected: Spelling error CODING GUIDELINES: Corrected: Spelling error
R4 · 2015-07-01 · v11
Revision Effective Date: 07/01/2015 (August Publication) NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Corrected code range listing Corrected: Spelling error CODING GUIDELINES: Corrected: Spelling error
R3 · 2015-07-01 · v9
Revision Effective Date: 07/01/2015 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: Drug name Akynzeo® CODING GUIDELINES: Removed: Drug name Akynzeo®
R3 · 2015-07-01 · v9
Revision Effective Date: 07/01/2015 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Removed: Drug name Akynzeo® CODING GUIDELINES: Removed: Drug name Akynzeo®
R2 · 2015-07-01 · v7
Revision Effective Date: 07/01/2015 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Q9978 for billing after 07/01/2015 CODING GUIDELINES: Added: Q9978 for billing after 07/01/2015
R2 · 2015-07-01 · v7
Revision Effective Date: 07/01/2015 NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES: Added: Q9978 for billing after 07/01/2015 CODING GUIDELINES: Added: Q9978 for billing after 07/01/2015
Receipts for auditors
Version 67 of Article A52480, shown on this page: in force by CMS's dates 2022-10-01 to 2022-09-30. 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 A52480 (44 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| Article A52480 | version 2 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 2 | 2015-10-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 5 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 5 | 2015-10-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 7 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 7 | 2015-10-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 9 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 9 | 2015-10-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 11 | 2015-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 11 | 2015-10-01 to 2015-12-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 15 | 2016-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 15 | 2016-01-01 to 2016-06-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 16 | 2016-07-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 16 | 2016-07-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 19 | 2016-07-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 19 | 2016-07-01 to 2016-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 28 | 2016-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 28 | 2016-10-01 to 2016-12-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 32 | 2017-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 32 | 2017-01-01 to 2017-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 39 | 2017-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 39 | 2017-10-01 to 2018-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 45 | 2018-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 45 | 2018-10-01 to 2018-12-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 48 | 2019-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 48 | 2019-01-01 to 2019-12-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 51 | 2020-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 51 | 2020-01-01, superseded same day | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 54 | 2020-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 54 | 2020-01-01 to 2021-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 58 | 2021-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 58 | 2021-10-01 to 2022-03-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 61 | 2022-04-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 61 | 2022-04-01 to 2022-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 67 shown | 2022-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 67 | 2022-10-01 to 2023-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 73 | 2023-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 73 | 2023-10-01 to 2024-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 80 | 2024-10-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 80 | 2024-10-01 to 2024-12-31 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 83 | 2025-01-01 to 2025-09-30 | 2026-10-02 | CMS's copy · Our archived file |
| Article A52480 | version 86 | 2025-10-01 to 2025-12-31 | 2026-10-09 | CMS's copy · Our archived file |
| Article A52480 | version 90 | 2026-01-01 to 2026-09-30 | 2026-09-26 | CMS's copy · Our archived file |
| Article A52480 | version 93 | 2026-10-01 to today | 2026-10-02 | CMS's copy · Our archived file |
Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.
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Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.