Chemotherapy Drugs and their Adjuncts
J5 · Effective Sep 16, 2017
50 active Medicare policies list Z94.84, and 10 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
J15 · Effective Oct 1, 2015
J9 · Effective Dec 30, 2019
JH · Effective Dec 30, 2019
JL · Effective Dec 30, 2019
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
10 policies from 4 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of Z94.84 |
|---|---|---|
| ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) | Oct 26, 2023 | Covered |
| Donor Lymphocyte Infusion | Sep 13, 2023 | Covered |
| Extracorporeal Photochemotherapy (Photopheresis) | Mar 29, 2023 | Covered |
| Palivizumab (Synagis) | Feb 15, 2024 | Covered |
| Polymerase Chain Reaction Testing: Selected Indications | Feb 9, 2024 | Covered |
| Varicella and Herpes Zoster Vaccines | Mar 22, 2023 | Covered |
J8 · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J15 · Effective Apr 17, 2022
JE · Effective Apr 17, 2022
JF · Effective Apr 17, 2022
JJ · Effective Apr 17, 2022
JM · Effective Apr 17, 2022
J5 · Effective Apr 17, 2022
J8 · Effective Apr 17, 2022
J6 · Effective Nov 1, 2022
JK · Effective Nov 1, 2022
J6 · Effective Jul 13, 2025
JK · Effective Jul 13, 2025
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J5 · Effective Nov 27, 2025
National · Effective Mar 5, 2026
National · Effective Jul 1, 2025
National · Effective Jul 1, 2025
National · Effective Jul 1, 2026
J5 · Effective Jul 1, 2026
National · Effective Jun 18, 2026
National · Effective Jul 1, 2026
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
National · Effective Aug 6, 2026
National · Effective Aug 6, 2026
National · Effective May 14, 2026
J5 · Effective Aug 6, 2026
J6 · Effective Jul 1, 2026
J6 · Effective Apr 1, 2026
National · Effective Oct 1, 2026
National · Effective Sep 3, 2026
National · Effective Jan 1, 2025
| Policy | Effective | Status of Z94.84 |
|---|---|---|
| Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation | Jul 1, 2026 | Covered |
| Therapeutic Apheresis | Apr 15, 2026 | Covered |
| Policy | Effective | Status of Z94.84 |
|---|---|---|
| Polymerase Chain Reaction Respiratory Viral Panel Testing | Not recorded | Covered |
| Policy | Effective | Status of Z94.84 |
|---|---|---|
| Flow Cytometry | Sep 15, 2026 | Covered |