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Billing and Coding: Neulasta® (pegfilgrastim) Onpro® Kit / UDENYCA® ONBODY (On-body Injector)
A54682
Effective: January 1, 2024
Updated: December 31, 2025
Policy Summary
Pegfilgrastim (Neulasta® or UDENYCA®) is covered to reduce the incidence of febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive chemotherapy with a clinically significant risk of febrile neutropenia. For Part B providers, use HCPCS J2506 or Q5111 plus CPT 96372 for prefilled syringe administration, and document/use CPT 96377 to identify on-body injector (Onpro®/ONBODY™) application; outpatient hospital payment for CPT 96377 is packaged into APCs and not separately payable.
Coverage Criteria Preview
Key requirements from the full policy
"Pegfilgrastim (Neulasta® or UDENYCA®) is covered to decrease the incidence of infection manifested by febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-c..."
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