Bisphosphonate Drug Therapy
J5 · Effective Oct 1, 2015
3 active Medicare policies list J3489, and 18 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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J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J5 · Effective Jan 1, 2026
18 policies from 7 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.
Showing 10 of 11 · All EviCore by Evernorth policies
| Policy | Effective | Status of J3489 |
|---|---|---|
| Reclast (zoledronic acid) Non-oncology | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Reclast (zoledronic acid)Effective 06/01/2024 - 05/31/2025 | Jun 1, 2024 | Prior auth requiredInferred from policy title |
| Reclast (zoledronic acid)Effective 06/01/2025 - 05/31/2026 | Jun 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 01/01/2020 - 08/30/2020 | Jan 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 03/01/2019 - 12/31/2019 | Mar 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 07/01/2022 - 06/30/2023 | Jul 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 07/01/2023 - 05/31/2024 | Jul 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 08/01/2021 - 06/30/2022 | Aug 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast) InjectionEffective 09/01/2020 - 07/31/2021 | Sep 1, 2020 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Zoledronic Acid (Reclast)Effective 06/01/2017 - 02/28/2019 | Jun 1, 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 J3489 |
|---|---|---|
| Zoledronic Acid (Reclast) | Jun 9, 2007 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Zoledronic Acid (Zometa) | Jun 9, 2007 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J3489 |
|---|---|---|
| Core Decompression for Avascular Necrosis | Oct 4, 2023 | Covered |
| Policy | Effective | Status of J3489 |
|---|---|---|
| Zometa (zoledronic acid) | 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 J3489 |
|---|---|---|
| Zoledronic Acid (Reclast); CP.PHAR.59 | 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 J3489 |
|---|---|---|
| Q4 - 2026 JHP MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J3489 |
|---|---|---|
| 00191 zoledronic acid (Zometa, Reclast)-Retired policy | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |