About this policy
CMS NCA document | source_status=Closed | review_type=New | public_comment_open=False | document_id=CAG-00248N
Coverage indications
CMS has determined that the evidence is adequate to conclude that the use of the oral anti-emetic three drug combination of aprepitant (Emend®), a 5-HT 3 antagonist, and dexamethasone is reasonable and necessary for a specified patient population. We have defined the patient population for which the use of the oral anti-emetic three drug combination of aprepitant (Emend®), a 5-HT 3 antagonist, and dexamethasone is reasonable and necessary as only those patients who: Are receiving one or more of the following anti-cancer chemotherapeutic agents: Carmustine, Cisplatin, Cyclophosphamide, Dacarbazine, Mechlorethamine, Streptozocin, Doxorubicin, Epirubicin, Lomustine
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Code | Code system | Status in this policy |
|---|---|---|
| J8501 | HCPCS | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |