White Cell Colony Stimulating Factors
JJ · Effective Jun 12, 2017
3 active Medicare policies list J1447, and 17 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JJ · Effective Jun 12, 2017
JM · Effective Jun 12, 2017
National · Effective Jul 1, 2026
17 policies from 15 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J1447 |
|---|---|---|
| Filgrastim (Neupogen) and Related Biosimilars, and tbo-filgrastim (Granix) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Filgrastim (Neupogen) and Related Biosimilars, and Tbo-filgrastim (Granix) | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Filgrastim (Neupogen) and Related Biosimilars, and tbo-filgrastim (Granix) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Filgrastim (Neupogen) and Related Biosimilars, and Tbo-filgrastim (Granix) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Donor Lymphocyte Infusion | Sep 13, 2023 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Tbo-filgrastim injection (Granix)Effective 12/15/2017 - 04/15/2019 | Dec 15, 2017 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Q4 - 2026 JHP MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Granulocyte Colony Stimulating Factor (G-CSF - Neupogen, Neulasta, Granix, Zarxio, Fulphila, Nivestym, Udenyca, Ziextenzo, Nyvepria) and Granulocyte-Macrophage Colony Stimulating Factor (GM-CSF - Leukine) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1447 |
|---|---|---|
| Short-Acting Granulocyte Colony Stimulating Factors (SA-gCSF): Filgrastim (Neupogen); Filgrastim-aafi (Nivestym); Filgrastim-sndz (Zarxio); Filgrastim-ayow (Releuko); Tbo-Filgrastim (Granix); Filgrastim-txid (Nypozi) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J1447 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |
| Policy | Effective | Status of J1447 |
|---|---|---|
| White Blood Cell Colony Stimulating Factors | Sep 1, 2026 | Covered |