Summary & Overview
HCPCS Level II J7508: Tacrolimus Extended-Release (Astagraf XL) Oral 0.1 mg
HCPCS Level II code J7508 designates the extended-release oral formulation of tacrolimus (Astagraf XL) at 0.1 mg strength, an immunosuppressive agent commonly used to prevent organ transplant rejection. Nationally, clear coding for branded oral immunosuppressants affects pharmacy billing, payer coverage determinations, and clinical continuity for transplant recipients and other patients on calcineurin inhibitor therapy.
This publication covers major payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of what J7508 represents clinically and operationally, the typical sites where this service is billed (outpatient pharmacy and clinic outpatient settings), and the implications for billing workflows.
The report provides benchmark context and policy-relevant information: coverage considerations by payer type, coding nuances for extended-release tacrolimus formulations, and common modifier usage (where available). It also outlines the clinical context for use of this medication and the service line typically associated with dispensing and outpatient administration. Data not provided in the input are noted as such where relevant.
Billing Code Overview
HCPCS Level II code J7508 represents Tacrolimus, extended release, (Astagraf XL), oral, 0.1 mg. This code is used to bill for the packaged, oral extended-release formulation of tacrolimus supplied as 0.1 mg strength.
Service type: Oral pharmaceutical / Prescription medication
Typical site of service: Outpatient pharmacy or clinic-based outpatient infusion/medication administration area where oral immunosuppressive therapy is dispensed
Clinical & Coding Specifications
Clinical Context
A typical patient is a 45-year-old renal transplant recipient receiving maintenance immunosuppression with extended‑release tacrolimus (J7508, Astagraf XL) to prevent allograft rejection. The patient presents to an outpatient transplant clinic or specialty pharmacy for prescription refill, medication counseling, and routine therapeutic drug monitoring. The clinical workflow includes a clinician (transplant nephrologist or advanced practice provider) assessing graft function and tacrolimus-related adverse effects, ordering trough tacrolimus blood level and basic metabolic panel, adjusting the daily oral extended‑release tacrolimus dose based on level and clinical status, and documenting the prescription for dispensing by an outpatient or specialty pharmacy. Typical sites of service are outpatient transplant clinic, specialty infusion/pharmacy dispensing location, and home administration by the patient. The medication is dispensed as an oral solid dosage form with follow-up lab monitoring and clinic visits scheduled per transplant center protocol.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Patient died during the postoperative period (historic CMS definition) | Rarely applicable; not typical for routine outpatient medication billing but used when reporting services for a patient who dies during the global period. |