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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j8521-capecitabine-oral-500mg
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    HCPCS J8521: Capecitabine, Oral, 500 mg

    HCPCS Level II code J8521 represents capecitabine, oral, 500 mg, a chemotherapy agent supplied for oral administration; the service type is oral chemotherapy dispensing/administration and the typical site of service is outpatient infusion/oncology clinic or outpatient pharmacy where oral anticancer medications are dispensed.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with stage III colon adenocarcinoma is prescribed oral capecitabine as adjuvant chemotherapy following surgical resection. The medication billed under J8521 is dispensed by an ambulatory oncology infusion pharmacy or outpatient specialty pharmacy and taken by the patient at home in scheduled cycles (commonly 14 days on, 7 days off). Clinical workflow includes chemotherapy ordering in the electronic medical record, verification by an oncology pharmacist, patient counseling on dosing and toxicities (hand-foot syndrome, diarrhea, myelosuppression), documentation of weight and renal function prior to each cycle, dispensing with appropriate labeling, and periodic oncology clinic visits for toxicity assessment and dose adjustments. Typical sites of service include outpatient infusion centers, hospital outpatient pharmacies, and specialty pharmacy dispensing with home administration by the patient.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96401Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplasticMay be used for parenteral chemotherapy administration when clinic visits include injectable supportive treatments alongside oral capecitabine.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommonly billed for oncology follow-up visits to assess tolerance and manage oral chemotherapy side effects.
    99406Smoking and tobacco-use cessation counseling visit, intermediateMay be billed if counseling is provided as part of supportive care during oncology treatment.
    99605Medication therapy management service(s) for one new patient during a 15-minute face-to-face visitUsed by pharmacists providing medication therapy management and counseling for complex oral chemotherapy regimens.
    96372Therapeutic, prophylactic, or diagnostic injection (specify drug)Billed when supportive agents (e.g., antiemetics, growth factors) are administered in clinic during cycles of oral chemotherapy.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RG0100XGastroenterology PhysicianAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    174400000XSpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    163WX0800XOrthopedic Registered NurseNursing Service Providers · Registered Nurse
    2251C2600XCardiopulmonary Physical TherapistA licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Cardiovascular & Pulmonary Physical T…
    101YP2500XProfessional CounselorBehavioral Health & Social Service Providers · Counselor

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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