2025 HCPCS code S0187
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Drugs - Non-Medicare Drug Codes Temporary National Codes (Non-Medicare) Feed
Tamoxifen citrate (10mg) oral administration; not reportable to Medicare.
Modifiers may be applicable depending on the circumstances of administration or dispensing.Consult payer-specific guidelines and current modifier information.
Medical necessity is established by a physician's order for tamoxifen citrate based on the patient's diagnosis (breast cancer or high risk for breast cancer), treatment plan, and medical history.Payer-specific guidelines and medical necessity criteria should be verified.
Oncologist, or other physician managing the patient's cancer care, is responsible for prescribing and monitoring tamoxifen therapy.Pharmacists dispense the medication.
In simple words: This code is for a drug called tamoxifen, which is used to treat and prevent breast cancer. One unit of this code represents 10 milligrams of the drug taken by mouth.This code is not used for billing Medicare.
HCPCS code S0187 represents the supply of 10 mg of tamoxifen citrate for oral administration.Tamoxifen citrate is a selective estrogen receptor modulator (SERM) used in the treatment and prevention of breast cancer.It works by blocking the action of estrogen, which is necessary for the growth of certain breast cancer cells. This code is specifically for non-Medicare billing and is not reportable to Medicare.
Example 1: A 50-year-old female patient diagnosed with estrogen receptor-positive breast cancer post-surgery receives a prescription for tamoxifen citrate as adjuvant therapy.The pharmacy bills for the medication using HCPCS code S0187., A 60-year-old female patient with a strong family history of breast cancer is prescribed tamoxifen citrate for breast cancer prevention. The physician's office, or the facility providing the medication, uses HCPCS code S0187 for billing., A 45-year-old male patient diagnosed with male breast cancer is prescribed tamoxifen citrate.Billing for the medication uses HCPCS code S0187 by the appropriate provider.
Prescription for tamoxifen citrate specifying dosage and quantity. Pharmacy dispensing records. Patient medical records including diagnosis and treatment plan.
** This code is specifically for non-Medicare billing.Always refer to the most current payer-specific guidelines for accurate billing and reimbursement.
- Payment Status: Active for non-Medicare payers
- Modifier TC rule: Not applicable. This code represents the supply of medication.
- Fee Schedule : Unknown.Fee schedules for HCPCS codes vary widely by payer and geographic location.Consult the specific payer's fee schedule for relevant information.
- Specialties:Oncology, Pharmacy
- Place of Service:Office, Pharmacy, Hospital Outpatient