Billing and Coding: Additional Claim Documentation Requirements for Not Otherwise Classified (NOC) Drugs and Biological Products with Specific FDA Label Indications
National · Effective Jun 12, 2025
1 active Medicare policy lists J9999, and 33 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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33 policies from 10 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of J9999 |
|---|---|---|
| Antineoplaston Cancer Therapy | Jan 1, 2026 | Covered |
| Denosumab and Biosimilars for Non-Oncologic Indications | Jan 1, 2026 | Covered |
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| FDA - Drugs, Biologicals, Cellular and Gene Therapies | Aug 1, 2026 | Covered |
| Immunoglobulin Therapy | Jan 1, 2026 | Covered |
| Oncology Medications | Jul 1, 2026 |
| Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Antineoplaston Cancer Therapy | Jan 1, 2026 | Covered |
| Denosumab and Biosimilars for Non-Oncologic Indications | Jan 1, 2026 | Covered |
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| FDA - Drugs, Biologicals, Cellular and Gene Therapies | Aug 1, 2026 | Covered |
| Immunoglobulin Therapy | Jan 1, 2026 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Antineoplaston Cancer Therapy | Jan 1, 2026 | Covered |
| Denosumab and Biosimilars for Non-Oncologic Indications | Jan 1, 2026 | Covered |
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| FDA - Drugs, Biologicals, Cellular and Gene Therapies | Aug 1, 2026 | Covered |
| Immunoglobulin Therapy | Jan 1, 2026 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Antineoplaston Cancer Therapy | Jan 1, 2026 | Covered |
| Denosumab and Biosimilars for Non-Oncologic Indications | Jan 1, 2026 | Covered |
| Eculizumab and Associated Biosimilar(s) | Dec 1, 2025 | Covered |
| FDA - Drugs, Biologicals, Cellular and Gene Therapies | Aug 1, 2026 | Covered |
| Immunoglobulin Therapy | Jan 1, 2026 | Covered |
| Oncology Medications | Jul 1, 2026 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Rituximab (Riabni, Rituxan, Ruxience, & Truxima) | Jan 1, 2026 | Covered |
| White Blood Cell Colony Stimulating Factors | Oct 1, 2025 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Rituximab (Riabni, Rituxan, Ruxience, & Truxima) | Jan 1, 2026 | Covered |
| White Blood Cell Colony Stimulating Factors | Oct 1, 2025 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Rituximab (Riabni, Rituxan, Ruxience, & Truxima) | Jan 1, 2026 | Covered |
| White Blood Cell Colony Stimulating Factors | Oct 1, 2025 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Tumor Chemosensitivity Assays | Mar 29, 2023 | Covered |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9999 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |