Summary & Overview
HCPCS S0108: Mercaptopurine, Oral, 50 mg
HCPCS Level II code S0108 designates mercaptopurine, oral, 50 mg — an antineoplastic agent used in chemotherapy regimens. Nationally, accurate coding for oral chemotherapeutic agents matters for appropriate billing, patient access, and drug management across outpatient settings. HCPCS Level II codes like S0108 help payers and providers identify specific drug products and dosages for coverage, prior authorization, and claims adjudication.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role and billing context, typical sites of service for administration and dispensing, and the payer landscape that commonly processes claims for oral chemotherapy. The publication also summarizes benchmarks and policy-relevant topics readers should expect: reimbursement coding practice for oral oncolytics, coverage and prior authorization patterns among major payers, and considerations for outpatient pharmacy versus clinic dispensing.
This summary provides clinicians, billing professionals, and policy stakeholders with a focused reference on how S0108 is used in practice, where claims typically originate, and which national payers commonly encounter this code.
Billing Code Overview
HCPCS Level II code S0108 represents Mercaptopurine, oral, 50 mg. This HCPCS code denotes a packaged or specifically billed oral chemotherapy agent supplied in a 50 mg dosage form.
Service Type: Oral antineoplastic/chemotherapy medication
Typical Site of Service: Outpatient pharmacy or clinic dispensing for ambulatory cancer care
Data not available in the input regarding associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with acute lymphoblastic leukemia (ALL) or inflammatory bowel disease (such as Crohn disease) receiving maintenance oral chemotherapy with mercaptopurine. The medication S0108 (mercaptopurine, oral, 50 mg) is dispensed by an outpatient pharmacy or provided as a take-home supply from an oncology clinic or infusion center. The clinical workflow begins with a hematology/oncology or gastroenterology visit where the prescribing clinician documents indication, weight-based dosing or mg/m2 dosing, baseline and ongoing laboratory monitoring requirements (complete blood count with differential and liver function tests), and evaluates drug interactions (for example with allopurinol or febuxostat). The prescription is transmitted to the specialty or outpatient pharmacy; the claim for the drug is billed under HCPCS Level II code S0108. Pharmacists provide counseling on administration, timing with meals, and toxicity monitoring. Clinical follow-up visits occur at intervals determined by risk and tolerance, during which dose adjustments are made based on labs and clinical status. Typical sites of service include outpatient oncology clinics, ambulatory infusion centers, specialty pharmacies, and hospital outpatient pharmacies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Service not otherwise specified |