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HCPCS Generic Name Brand Name Strength SEER*Rx Category (Ascending) Major Drug Class Minor Drug Class Oral (Y/N) FDA Approval Year FDA Discontinuation Year CMS Effective Date CMS Discontinuation Date Status
J1627 Granisetron Hydrochloride Extended Release Granisol [DSC], Sancuso, Sustol, Kytril 0.1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 2016 Jan. 1, 2018 In Use
J1626 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 100 mcg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 1993 Jan. 1, 2009 In Use
Q0166 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan. 1, 2009 In Use
S0091 Granisetron Hydrochloride Granisol [DSC], Sancuso, Sustol, Kytril 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1993 Jan. 1, 2002 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 10 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 15 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 In Use
NA Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 25 mg Ancillary Therapy Chemoprotective Antidote Yes 1952 Jan. 1, 1997 In Use
J0640 Leucovorin Calcium Calcium leucovorin, Lederfoline, Leucosar, Leucovorin rescue, Wellcovorin 50 mg Ancillary Therapy Chemoprotective Antidote No 1952 Jan. 1, 1997 In Use
J0641 Levoleucovorin Fusilev 0.5 mg Ancillary Therapy Chemoprotective Antidote No 2008 Jan. 1, 2009 In Use
NA Mesna Mesnex 400 mg Ancillary Therapy Chemoprotective Detoxifying Agent Yes 2002 In Use
J9209 Mesna Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan 200 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1988 Jan. 1, 1990 In Use
C9428 Mesna Mesna rescue, Mesnex, Mesna Novaplus, Uromitexan 200 mg Ancillary Therapy Chemoprotective Detoxifying Agent No 1988 Jan. 1, 2004 Dec. 31, 2005 No Longer Used
J8650 Nabilone Cesamet 1 mg Ancillary Therapy Antiemetic Cannabinoid Yes 1985 Jan. 1, 2007 In Use
J8655 Netupitant/palonostron Akynzeo 300mg/0.5 mg Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Yes 2014 Jan. 1, 2016 In Use
Q9978 Netupitant/palonostron Akynzeo 300mg/0.5 mg Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Yes 2014 July 1, 2015 Dec. 31, 2015 No Longer Used
C9448 Netupitant/palonostron Akynzeo 300mg/0.5 mg Ancillary Therapy Antiemetic 5HT3 Receptor Anatagonist/Substance P/Neurokinin 1 Yes 2014 April 1, 2015 June 30, 2015 No Longer Used
J2405 Ondansetron Zofran, Zofran ODT, Zuplenz 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 1991 Jan. 1, 1993 In Use
Q0179 Ondansetron Zofran, Zofran ODT, Zuplenz 8 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 April 1, 1998 Dec. 31, 2011 No Longer Used
Q0162 Ondansetron with active chemotherapy treatment adminstration Zofran, Zofran ODT, Zuplenz 1 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Jan. 1, 2012 In Use
S0181 Ondansetron Zofran, Zofran ODT, Zuplenz 4 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Jan. 1, 2002 Dec. 31, 2011 No Longer Used
S0119 Ondansetron Zofran, Zofran ODT, Zuplenz 4 mg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist Yes 1991 Jan. 1, 2012 In Use
NA oxymetholone Anadrol-50 50 mg Ancillary Therapy Anabolic Steroid Androgen Yes 1972 In Use
J2425 Palifermin Kepivance 50 mcg Ancillary Therapy Epithelial Growth Factor Keratinocyte Growth Factor/rHuKGF No 2004 Jan. 1, 2006 In Use
C9210 Palonosetron Aloxi 25 mcg Ancillary Therapy Antiemetic 5HT3 Receptor Antagonist No 2003 Jan. 1, 2004 Dec. 31, 2004 No Longer Used

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The use of NA indicates that the HCPCS code was Not Available. NA may mean that a) the HCPCS code has not yet been created (new drug), b) the drug is given as an oral drug or alternative route (only in specific instances are HCPCS assigned to these medications), or c) the HCPCS could not be found or is truly not available.