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Oncology & Hematology Coding Alert

Chemotherapy:

96402 Is Not an Option for Lupron Depot Admin, Noridian Says

Published on Tue Apr 12, 2011

Lesson: Don't assume every J9xxx code qualifies for chemotherapy administration codes.If your practice sees patients with Part B coverage through Noridian, you'll need to take note of a new drug administration rule from this Medicare Administrative Contractor (MAC). Being in the know will help you properly report gonadotropinreleasing hormone (GnRH) injections.This rule affects practices in Arizona, Utah, North Dakota, South Dakota, Wyoming, and Montana, with Noridian Administrative Services as their MAC, as well as practices in Alaska, Oregon, and Washington, which Noridian covers under a legacy contract.Learn the Crux of the ChangeAs of March 1, 2011, you shouldn't be using administration code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal antineoplastic) or any other chemotherapy administration code with some agents as you have in the past. According to Noridian, the administration of GnRH, also known as luteinizinghormone releasing hormones (LHRH), or its analogs, does not meet the CPT manual requirements for [...]
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