|
J8501 |
 |
Aprepitant, oral, 5 mg
| short | Oral aprepitant |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 57.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 57.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
J8510 |
|
Busulfan; oral, 2 mg
| short | Oral busulfan |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 5.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8515 |
|
Cabergoline, oral, 0.25 mg
| short | Cabergoline, oral 0.25mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
J8520 |
|
Capecitabine, oral, 150 mg
| short | Capecitabine, oral, 150 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 50.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8521 |
|
Capecitabine, oral, 500 mg
| short | Capecitabine, oral, 500 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 15.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8530 |
|
Cyclophosphamide; oral, 25 mg
| short | Cyclophosphamide oral 25 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 60.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 180.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
J8540 |
|
Dexamethasone, oral, 0.25 mg
| short | Oral dexamethasone |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 48.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | DME | 216.0 | 3 Date of Service Edit: Clinical | Clinical: Society Comment |
|
|
|
|
J8560 |
|
Etoposide; oral, 50 mg
| short | Etoposide oral 50 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 6.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8562 |
|
Fludarabine phosphate, oral, 10 mg
| short | Oral fludarabine phosphate |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 12.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8565 |
|
Gefitinib, oral, 250 mg
| short | Gefitinib oral |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
J8597 |
|
Antiemetic drug, oral, not otherwise specified
| short | Antiemetic drug oral nos |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 4.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
J8600 |
|
Melphalan; oral, 2 mg
| short | Melphalan oral 2 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 40.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8610 |
|
Methotrexate; oral, 2.5 mg
| short | Methotrexate oral 2.5 mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 20.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | DME | 12.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
J8650 |
|
Nabilone, oral, 1 mg
| short | Nabilone oral |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | DME | 14.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
J8655 |
|
Netupitant 300 mg and palonosetron 0.5 mg, oral
| short | Oral netupitant, palonosetro |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | DME | 1.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8670 |
|
Rolapitant, oral, 1 mg
| short | Rolapitant, oral, 1mg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 180.0 | 3 Date of Service Edit: Clinical | Prescribing Information | | DME | 180.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
J8700 |
|
Temozolomide, oral, 5 mg
| short | Temozolomide |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 120.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8705 |
|
Topotecan, oral, 0.25 mg
| short | Topotecan oral |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | Oral Medication; Not Payable | | OPH | 22.0 | 3 Date of Service Edit: Clinical | Prescribing Information |
|
|
|
|
J8999 |
|
Prescription drug, oral, chemotherapeutic, nos
| short | Oral prescription drug chemo |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|