Capecitabine Oral Anti-Cancer Drug Billing Instructions

These instructions apply to Capecitabine Oral Anticancer Drugs billed under the Oral Anticancer Drugs Local Coverage Determination (LCD L33826):

• Dates of service October 1 – December 31, 2024 (J8520 and J8521):
  • Bill these drugs with HCPCS code J8999 (Prescription drug, oral, chemotherapeutic, NOS) until J8522 [Capecitabine (Xeloda)] is implemented in the system.
  • Do not bill these drugs using the National Drug Code (NDC)
  • Claim narrative field: Drug name (Capecitabine or Xeloda) Dosage, and National Drug Code (NDC).
• Dates of service on or after January 1, 2025:
  • Bill these drugs with the NDC instead of a HCPCS code. This is consistent with billing other drugs under the Oral Anti-Cancer LCD.

The NDC is a number which uniquely identifies a manufacturer's product in terms of the strength of each tablet, quantity of tablets in a package, and other packaging details. Suppliers must use the NDC that matches the product dispensed. Do not use HCPCS J codes for capecitabine prescribed for use as an oral anti-cancer drug for dates of service on or after January 1, 2025.

Post Date: 09/10/2025