Does your use sees patients with Part B coverage through Noridian? If so, you will distress to take note of a just discovered drug administration rule from this Medicare Administrative Contractor (MAC). Being well-clever with all the recent happenings power of choosing help you report gonadotropinreleasing hormone (GnRH) injections the as it should be way.
This rule will have every impact on practices in Arizona, Utah, North Dakota, South Dakota, Wyoming, and Montana, with Noridian Administrative Services as their MAC, in company with practices in Alaska, Oregon, and Washington, which Noridian covers under a legacy get.
Reason for the change
From March 1, you cannot application administration code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal antineoplastic) or in ~ degree other chemotherapy administration code with some agents as you have done in anterior occasions.
The administration of GnRH (in like manner known as luteinizinghormone releasing hormones -LHRH, or its analogs) doesn't meet the CPT manual requirements for the conversion to an act of the chemotherapy administration codes.
The notice of Nordian doesn't allow in ~ degree additional rationale to explain why the MAC is treating Lupron Depot, a biological rejoinder modifier, as a less complex curative administration. Abbott's package insert because dosage and administration of Lupron Depot talks not far from the great instability of the medication and the uncommon care needed to administer it suitably.
Official version: The information below was published by Nordian in the March 2, 2011, Medicare B News, Issue 268, and placed it as news on Jan. 21, this year: Medicare takes the exercise of the chemotherapy administration codes to suitably describe the parenteral administration of the sole following drugs - J1745 Injection Infliximab, Any non-GnRH mix with ~s/compound listed in the present HCPCS section – chemotherapy drugs J9000-J9999, instances of GnRH and analogs hold however are not confined to J9217 and J9218.
From April 2010, come the timeline
The March 2, 2011, proclamation points to it updates of the June 2, 2010, Medicare B News, Issue 262. Remember that this rendition does not reference GnRH coding:
Any medicine listed in the present HCPCS portion - 'CHEMOTHERAPEUTIC DRUGS J9000-J9999' and the biologic answer modifier, J1745 Injection Infliximab, 10 mg.
However gripe on, there's more: On May 6, latest year, Nordian posted an update competent as of June 15, last year, specifically referencing J9217 and J9218: Medicare takes the practice of the chemotherapy administration codes to strictly describe the parenteral administration of alone the following drugs: J1745 Injection Infliximab.
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