Chemotherapy Drugs and their Adjuncts
J5 · Effective Sep 16, 2017
4 active Medicare policies list J9190, and 14 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 Sep 16, 2017
J8 · Effective Sep 16, 2017
National · Effective Jan 25, 2026
J5 · Effective Nov 27, 2025
14 policies from 12 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 J9190 |
|---|---|---|
| Glaucoma Surgery | Mar 24, 2023 | Covered |
| Hypertrophic Scars and Keloids | Jun 22, 2023 | Covered |
| Policy | Effective | Status of J9190 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Scar Revision | Jun 15, 2026 | Covered |
| Policy | Effective | Status of J9190 |
|---|---|---|
| Genetic Test: Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients with Cancer | 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 J9190 |
|---|---|---|
| Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer | 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 J9190 |
|---|---|---|
| GENETIC AND LABORATORY TESTING FOR USE OF FLUOROPYRIMIDINES (E.G., 5-FLUOROURACIL AND CAPECITABINE) IN PATIENTS WITH CANCER | 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 J9190 |
|---|---|---|
| Testing for 5-Fluorouracil Use in Cancer Patients AHS - M2067 | 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 J9190 |
|---|---|---|
| Therapeutic Drug Monitoring for 5-Fluorouracil | 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 J9190 |
|---|---|---|
| Fluorouracil Cream (Tolak); CP.PMN.165 | 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 J9190 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |
| Policy | Effective | Status of J9190 |
|---|---|---|
| Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer | 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 J9190 |
|---|---|---|
| 00291 Laboratory and Genetic Testing for Use of 5-Fluorouracil in Patients With Cancer- Retired Policy | 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 J9190 |
|---|---|---|
| 15.01.044 Therapeutic Drug Monitoring for 5-Fluorouracil | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |