TrailBlazer Updates LCD for Chemo Drugs

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  • June 29, 2009
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Medicare Administrative Contractor (MAC) TrailBlazer recently announced an inadvertent coding error. ICD-9-CM diagnosis code 238.79 Other lymphatic and hematopoietic tissues, used to indicate B-cell lymphoproliferative disorders expressing the CD-20 antigen as a covered diagnosis for J9310 Injection, rituximab, 100 mg, should be replaced with ICD-9-CM diagnosis code 238.77 Post-Transplant Lymphoproliferative Disorder (PTLD).

TrailBlazer has made this change in the most recent version of each Local Coverage Determination (LCD) listed below:

For jurisdiction 4 (J4) (Colorado, New Mexico, Oklahoma, and Texas):

Drugs and Biologicals – Chemotherapeutic – 4I-92AB

For Part B Virginia:

Drugs and Biologicals – Chemotherapeutic Drugs J9000–J9999 – I-68B

This change is effective with claims submitted on or after July 17 for dates of service on or after Oct. 1, 2008.

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