Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.1

Oral Cancer Drugs

Last amended: 2003Year: 2003Length: 95 wordsOfficial source
80.1 - Oral Cancer Drugs (Rev. 1, 10-01-03) A3 3660.13, SNF 536.1 Effective January 1, 1994, oral self administered versions of covered injectable cancer drugs furnished may be paid if other coverage requirements are met. To be covered the drug must have had the same active ingredient as the injectable drug. Effective January 1, 1999, this coverage was expanded to include FDA approved Prodrugs used as anti-cancer drugs. A Prodrug may have a different chemical composition than the injectable drug but body metabolizing of the Prodrug results in the same chemical composition in the body.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 80.1: Oral Cancer Drugs | Justis AI