Local Coverage Determination · DME MAC
L33824
Immunosuppressive Drugs
Version 60. CMS effective date 10/01/2026. CMS updated 09/23/2026. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation. None
Coverage indication
In addition to the “reasonable and necessary” criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. For the items addressed in this LCD, the “reasonable and necessary” criteria, based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. The statutory coverage criteria for immunosuppressive drugs are specified in the related Policy Article. For immunosuppressive drugs covered under this policy, the dosage, frequency and route of administration must conform to generally accepted medical practice and must be medically necessary to prevent or treat the rejection of an organ transplant. Coverage of parenteral azathioprine (J7501) or methylprednisolone (J2919) is limited to those situations in which the medication cannot be tolerated or absorbed if taken orally and is self-administered by the beneficiary.
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
- A52474 · Immunosuppressive Drugs - Policy Article
HCPCS codes on this LCD
29 other Level II codes are on the LCD and are not given a page in this set: J2919, J7500, J7501, J7502, J7503, J7504, J7507, J7508, J7509, J7510, J7511, J7512, J7515, J7516, J7518, J7520, J7521, J7524, J7525, J7527, J7529, J7530, J7531, J7599, J8530, J8610, Q0510, Q0511, Q0512.
Questions
What does LCD L33824 cover?
L33824 is Immunosuppressive Drugs. It is a current final DME MAC local coverage determination, version 60.
Where is the CMS source for L33824?
The Medicare Coverage Database page for LCD L33824 version 60.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=J0485&as_of=2024-01-15&npi=1234567890&state=UT"