Oncology & Hematology Coding Alert

Question: How do we code for Adcetris administration? Virginia Subscriber Answer: According to Palmetto GBA, J11 Part B MAC for Virginia, you should submit the following: CPT®: 96413, Chemotherapy administration, intravenous infusion technique; up to one hour HCPCS: J9999, Not otherwise classified antineoplastic drugs ICD-9: 200.60-200.68 (Anaplastic large cell lymphoma) or 201.00-201.98 (Hodgkin's disease), depending on documentation. Enter a single unit for the HCPCS code. A 30 minute IV infusion is the typical administration method, which would equal a single unit of 96413. You'll also need to include specific information in the comment field for Palmetto: NDC number Adcetris Dose given. Finally, be sure to send a copy of the invoice. The MAC states, "Until Palmetto GBA receives enough claims to determine a price, providers must submit an invoice copy for this drug." To find the directions for J11 providers, head to www.palmettogba.com/palmetto/providers.nsf/DocsCatHome/Jurisdiction%2011%20Part%20B and enter "Adcetris" in the Search [...]