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Scrap 96402 For Lupron Injections in Noridian Patients

Published on Tue Mar 15, 2011

Apply the new rule to claims after March 1.If your practice sees patients with insurance coverage through Noridian, you'll need to take note of a new chemotherapy drug administration rule from the Medicare Administrative Contractor (MAC). Ensure you're properly reporting Lupron injections for these patients before you start seeing denials.This will affect practices in Arizona, Utah, North Dakota, South Dakota, Wyoming, and Montana, with Noridian Administrative Services as their MAC.Learn the Reason for the ChangeAs of March 1, 2011 you won't be able to use administration code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic) with some drugs as you have in the past.According to information that Noridian first released on May 6, 2010, the preparation and administration of Gonadotropinreleasing hormones (GnRH), also known as luteinizing-hormonereleasing hormones (LHRH) does not meet the CPT manual requirements of the use of the chemotherapy administration codes.Noridian issued a notice that stated: "Medicare considers [...]
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