Omalizumab (Xolair) (J2357): Medicare covered diagnoses & ICD-10 codes

Xolair · Medicare Part B (physician-administered) · 17 covered ICD-10 codes

Medicare pays for Omalizumab (Xolair) (J2357) under Part B when the claim carries a covered diagnosis. National Government Services, Inc. defines local coverage in Billing & Coding Article A52448 (LCD L33394), which lists 17 covered ICD-10 codes — the complete, current list is below, grouped by condition. CMS last revised this article 09/17/2025; we reviewed it Jun 29, 2026.

Page reviewed Jun 29, 2026 · from CMS Article A52448 (CMS last revised 09/17/2025)

Quick answer

Medicare benefit
Part B (physician-administered)
Covered diagnoses
17 ICD-10 codes
Governing policy
A52448 / L33394
Contractor (MAC)
National Government Services, Inc.
CMS article revised
09/17/2025
Page reviewed
Jun 29, 2026
HCPCS codes covered:
J2357Q5154
Coverage varies by Medicare Administrative Contractor (MAC). This list is National Government Services, Inc.'s policy (Article A52448), which administers Part B in Illinois, Minnesota, Wisconsin, Connecticut, Maine, Massachusetts +4 more. In another state? Other MACs may publish a different covered list — find your MAC by state →

What Medicare pays for Omalizumab (Xolair) (2026 Q2)

Once a claim carries a covered diagnosis, Medicare Part B reimburses the drug at the ASP + 6% payment limit. Current allowed amounts per billing unit:

HCPCSDescriptionPer unitAllowed (ASP + 6%)
J2357Omalizumab injection5 mg$41.823

Source: CMS ASP Drug Pricing File, 2026 Q2. Payment = ASP + 6% per unit; multiply by units billed (watch JZ/JW wastage). Your patient's share is typically 20% after the deductible. Estimate the full cost & patient out-of-pocket →

Omalizumab (Xolair) is a physician-administered biologic billed under Medicare Part B (not the Part D pharmacy benefit). Under Part B, Medicare pays the practice for the drug (HCPCS J2357) plus its administration — but only when the claim's diagnosis (ICD-10) code supports medical necessity. Each MAC publishes the specific covered diagnoses in a Billing & Coding Article; a claim with a diagnosis outside that list is typically denied as not medically necessary (CO-50).

Covered ICD-10 diagnoses for Omalizumab (Xolair)

The 17 codes below are the diagnoses National Government Services, Inc. accepts for J2357 under Article A52448, grouped exactly as CMS groups them and organized by condition category for scanning. Use the filter in each group to find a specific code or condition.

Group 1 — 17 covered diagnoses

Diseases of the respiratory system (7)

ICD-10Covered diagnosis
J33.0Polyp of nasal cavity
J45.40Moderate persistent asthma, uncomplicated
J45.41Moderate persistent asthma with (acute) exacerbation
J45.42Moderate persistent asthma with status asthmaticus
J45.50Severe persistent asthma, uncomplicated
J45.51Severe persistent asthma with (acute) exacerbation
J45.52Severe persistent asthma with status asthmaticus

Diseases of the skin & subcutaneous tissue (4)

ICD-10Covered diagnosis
L50.1Idiopathic urticaria
L50.6Contact urticaria
L50.8Other urticaria
L50.9Urticaria, unspecified

Injury, poisoning & external causes (3)

ICD-10Covered diagnosis
T78.40XAAllergy, unspecified, initial encounter
T78.40XDAllergy, unspecified, subsequent encounter
T78.40XSAllergy, unspecified, sequela

Factors influencing health status (3)

ICD-10Covered diagnosis
Z91.010Allergy to peanuts
Z91.013Allergy to seafood
Z91.040Latex allergy status

How to use this list when billing

Put the patient's covered ICD-10 diagnosis on the claim line with J2357 and confirm your documentation supports medical necessity. Match the right product code (reference vs biosimilar) and units, and check the diagnosis against the article for your MAC, since the list above is National Government Services, Inc. policy.

LCD vs. Billing & Coding Article vs. NCD

An LCD (Local Coverage Determination) is a MAC's policy on whether a service is reasonable and necessary in its region, and its companion Billing & Coding Article holds the covered ICD-10 and HCPCS code lists. A NCD (National Coverage Determination), where one exists, applies nationwide. For Omalizumab (Xolair), the code lists live in Article A52448 (tied to LCD L33394) — CMS moved code lists out of LCDs and into Articles, which is why the diagnoses live in the Article, not the LCD.

Common Omalizumab (Xolair) denial reasons

What you seeWhyFix
CO-50 — not medically necessaryDiagnosis not in the covered list for J2357Bill a covered ICD-10 from the groups above, or document an exception
Diagnosis/units mismatchRight dx but wrong product code or unit countMatch the J/Q code and units to the drug actually given (check JZ/JW wastage)
Covered by one MAC, denied by anotherYou used a different region's covered listUse the Article for your MAC (coverage varies)
Non-covered / statutorily excluded dxDiagnosis is on the non-covered listConfirm against the Article's non-covered ICD-10 group

Frequently asked questions

Is Omalizumab (Xolair) covered by Medicare?
Yes. Omalizumab (Xolair) (J2357) is covered under Medicare Part B as a physician-administered drug when billed for a medically necessary, covered diagnosis. Local coverage is defined by National Government Services, Inc. in Billing & Coding Article A52448, tied to LCD L33394.
What diagnoses are covered for Omalizumab (Xolair) (J2357)?
Medicare lists 17 covered ICD-10 diagnosis codes for J2357 under Article A52448. The full list is on this page, grouped by condition category. Coverage can vary by Medicare Administrative Contractor (MAC); confirm against the article that applies in your state.
Which Medicare policy covers Omalizumab (Xolair)?
Billing & Coding Article A52448 (v23), tied to LCD L33394 (“Drugs and Biologicals, Coverage of, for Label and Off-Label Uses”), published by National Government Services, Inc. and last updated 09/17/2025.
Why was my Omalizumab (Xolair) claim denied as not medically necessary?
The most common cause is an ICD-10 diagnosis on the claim that is not in the covered list for J2357. Confirm the patient's diagnosis is in the groups below, that documentation supports medical necessity, and that you are using the article for your MAC.

Related references

Covered is only half the answer.

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Estimate Omalizumab (Xolair) cost & patient owe →

Source & verification

Source
CMS Medicare Coverage Database — Billing & Coding Article A52448 (v23), LCD L33394 “Drugs and Biologicals, Coverage of, for Label and Off-Label Uses” — National Government Services, Inc..
CMS article last revised
09/17/2025 — the most recent revision CMS has published for this article.
Page last reviewed by CareCost
Jun 29, 2026 (coverage data retrieved 2026-06-28; we re-verify against CMS quarterly).
Code licensing
ICD-10-CM codes are public domain (CMS/CDC). CPT® codes are AMA-copyrighted and are intentionally not listed here — see the administration-code reference for those.
Not advice
This is general billing reference, not legal or billing advice. Always verify against the LCD/Article that applies to your MAC and patient.
How we build this
Compiled programmatically from the CMS Coverage API and reviewed by the CareCost Estimate editorial team against the source article. See our methodology and editorial policy.
Spotted an error?
Email editorial@carecostestimate.com.