Neurology & Pain Management Coding Alert

Neurology practices offering, or planning to offer, Tysabri infusions for multiple sclerosis patients now face an even steeper challenge than conflicting coding guidelines.

Biogen Idec and Elan Pharmaceuticals, the makers of Tysabri, have pulled the drug from the market.
 
Although you can expect payers to discontinue immediately all reimbursement for Tysabri infusions, you should still seek compensation for services provided prior to the recall date (see Neurology Coding Alert, April 2005, for complete information on Tysabri billing).

In a Feb. 28 announcement, Biogen and Elan announced that they "are suspending supply of Tysabri from commercial distribution, and physicians should suspend dosing of Tysabri until further notification."

The suspension follows "recent reports of two serious adverse events that have occurred in patients treated with Tysabri in combination with Avonex (Interferon beta-1a) in clinical trials," including at least one fatal case of progressive multifocal leukoencephalopathy (PML), a rare and frequently fatal, demyelinating disease of the central nervous system.

"Because we believe in the promising therapeutic benefit of Tysabri, we are working to evaluate this situation thoroughly and expeditiously," says Burt Adelman, MD, executive vice president, development, Biogen Idec. "While we work through this matter, we must place patient safety above all other considerations." Biogen and Elan may, however, rerelease Tysabri following investigation.

Learn more: For complete information on the Tysabri suspension, visit www.biogen.com.