Oncology & Hematology Coding Alert

In the February issue of Oncology Coding Alert, Key to Ondansetron Coverage Lies in Toxicity of Chemotherapy, it was incorrectly stated that:

Margaret Hickey, MS, MSN, RN, OCN, CORLN, an independent coding consultant and former clinical director at the Tulane Cancer Center in New Orleans, says that Medicare and other payers have a pecking order in their formulary that requires oncologists to use other specific antiemetics before ondansetron can be used and reimbursed.

This information was misquoted in relation to Medicare coverage and reimbursement for Zofran (ondansetron). It was originally stated that private insurance companies, specifically HMOs, have a pecking order. As a result, we are retracting the entire quote and the rest of the second paragraph of that article.

HCFA has not issued any directives that require oncologists to use other specific antiemetics before Zofran is eligible for Medicare coverage and reimbursement. Providers should contact their local Medicare contractors for additional information. Most will have published local or regional medical review policies to educate the provider community about existing Zofran coverage and requirements.

We apologize for any inconvenience this has caused.