Hepatocellular (Liver) Cancer and Renal Cell Carcinoma
|
|
- Bartholomew Atkinson
- 7 years ago
- Views:
Transcription
1 Drug & Administration compendia Treatment of Hepatocellular (Liver) Cancer and Renal Cell Carcinoma With each publication, ManagedCare Oncology s Drug & Administration Compendia highlights a single medication or a group of medications that could be utilized in the management of one of the featured oncology diseases. This section addresses such topics as: Associated ICD-9-CM codes Drugs that have been FDA-approved Drugs that are compendia-listed for off-label use based on clinical studies that suggest beneficial use in some cases Ancillary medications used in cancer treatment Reimbursement and coding information HCPCS/CPT codes and code description Current code price (AWP-based pricing) Most recent allowable (ASP + 6 percent), if applicable Possible CPT administration codes that can be utilized with each drug Associated ICD-9-CM Codes: Hepatocellular (Liver) Cancer 155 Malignant neoplasm of liver and intrahepatic bile ducts Liver, primary Carcinoma: Hepatocellular Liver cell Liver, specified as primary Hepatoblastoma Renal Cell Carcinoma 189 Malignant neoplasm of kidney and other unspecified urinary organs Excludes Benign carcinoid tumor of kidney (209.64) Malignant carcinoid tumor of kidney (209.42) Kidney, except pelvis Kidney NOS Kidney parenchyma 28 managedcareoncology Quarter
2 FDA-Approved Medications Currently Available to Treat Hepatocellular (Liver) Cancer Allowable sorafenib (Nexavar) sorafenib (Nexavar) Compendia-Listed Off-Label Use Medications Currently Available to Treat Hepatocellular (Liver) Cancer Allowable cisplatin (Platinol AQ) doxorubicin (Adriamycin) epirubicin (Ellence) J9060 cisplatin, powder or solution, per 10 mg J9000 doxorubicin hydrochloride, 10 mg J9178 epirubicin hydrochloride, 2 mg $4.33 $ , 96413, $13.20 $ $5.38 $ , etoposide (VePesid) J8560 etoposide, oral, 50 mg $63.06 $47.13 N/A etoposide (Toposar) J9181 etoposide, 10 mg $0.53 $ , floxuridine (FUDR) J9200 floxuridine, 500 mg $ $ , 96423, fluorouracil (Adrucil) J9190 fluorouracil, 500 mg $3.30 $ gemcitabine (Gemzar) J9201 gemcitabine hydrochloride, 200 mg $ $ ifosfamide (Ifex) J9208 ifosfamide, 1 g $42.00 $ , interferon alfa-2b (Intron-A) lanreotide acetate (Somatuline Depot) J9214 interferon alfa-2b, recombinant, 1 million units J1930 lanreotide, 1 mg (code reused by CMS effective 1/1/09) $21.90 $ , $37.15 $ mitomycin (Mutamycin) J9280 mitomycin, 5 mg $67.20 $ mitoxantrone (Novantrone) octreotide acetate (Sandostatin) tamoxifen (Nolvadex) J9293 mitoxantrone hydrochloride, per 5 mg J2354 octreotide, nondepot form for subcutaneous or intravenous 25 mcg $90.00 $ , $2.50 $ , 96372, tamoxifen (Nolvadex) S0187 tamoxifen citrate, oral, 10 mg $1.89 S0187 not payable by N/A vincristine (Vincasar PFS) J9370 vincristine sulfate, 1 mg $5.60 $ *When billing a nonclassified medication using a CMS 1500 claim form, you must include both the HCPCS code (i.e., J8999 for Nexavar) in column 24D and the drug name, strength and National Drug Code (NDC) in box 19 to ensure appropriate reimbursement. managedcareoncology.com 29
3 FDA-Approved Medications Currently Available to Treat Renal Cell Carcinoma Allowable aldesleukin (Proleukin) J9015 aldesleukin, per single-use vial $1, $1, axitinib (Inlyta) axitinib (Inlyta) bevacizumab (Avastin) J9035 bevacizumab, 10 mg $71.61 $ , everolimus (Afinitor) medroxyprogesterone J1051 medroxyprogesterone acetate, $11.12 $ (Depo-Provera) 50 mg pazopanib (Votrient) pazopanib (Votrient) sorafenib (Nexavar) sorafenib (Nexavar) sunitinib (Sutent) NDC level pricing NDC level pricing sunitinib (Sutent) temsirolimus (Torisel) J9330 temsirolimus, 1 mg $62.31 $ *When billing a nonclassified medication using a CMS 1500 claim form, you must include both the HCPCS code (i.e., J8999 for Nexavar) in column 24D and the drug name, strength and National Drug Code (NDC) in box 19 or 24A to ensure appropriate reimbursement. Please note: Check with payor regarding correct placement of medication information. 30 managedcareoncology Quarter
4 Compendia-Listed Off-Label Use Medications Currently Available to Treat Renal Cell Carcinoma Allowable capecitabine (Xeloda) J8520 capecitabine, oral, 150 mg $9.77 $7.86 N/A capecitabine (Xeloda) J8521 capecitabine, oral, 500 mg $32.57 $26.02 N/A floxuridine (FUDR) J9200 floxuridine, 500 mg $ $ , 96423, fluorouracil (Adrucil) J9190 fluorouracil, 500 mg $3.30 $ gemcitabine (Gemzar) J9201 gemcitabine hydrochloride, $ $ mg interferon alfa-2b (Intron-A) J9214 interferon alfa-2b, recombinant, $21.90 $ , million units interferon alfa-n3 (Alferon N) J9215 interferon alfa-n3 (human $36.14 N/A 11900, leukocyte derived), 250,000 IU interferon gamma-1b J9216 interferon gamma-1b, $ $ (Actimmune) 3 million units peginterferon alfa-2a (Pegasys) J3590* unclassified biologics NDC level pricing NDC level pricing peginterferon alfa-2a (Pegasys) S0145 pegylated interferon alfa-2a, 180 mcg per ml $ S0145 not payable by pemetrexed (Alimta) J9305 pemetrexed, 10 mg $65.93 $ sargramostim (Leukine) J2820 sargramostim (GM-CSF), 50 mcg $47.36 $ , 96366, thalidomide (Thalomid) vinblastine (Velban) J9360 vinblastine sulfate, 1 mg $3.18 $ *When billing a nonclassified medication using a CMS 1500 claim form, you must include both the HCPCS code (i.e., J8999 for Nexavar) in column 24D and the drug name, strength and National Drug Code (NDC) in box 19 or 24A to ensure appropriate reimbursement. Please note: Check with payor regarding correct placement of medication information Ancillary Medications Used in Cancer Treatment Allowable aprepitant (Emend) J8501 aprepitant, oral, 5 mg $8.00 $6.17 N/A granisetron (Kytril) J1626 granisetron hydrochloride, $3.93 $ mcg granisetron (Kytril) Q0166 granisetron hydrochloride, 1 mg oral, $59.01 $1.26 N/A FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at time of chemotherapy treatment, not to exceed a 24-hour dosage regimen see also S0091 granisetron (Kytril) S0091 granisetron hydrochloride, 1 mg (For $59.01 S0091 not payable by N/A circumstances falling under the statute, use Q0166.) ondansetron (Zofran) J2405 ondansetron hydrochloride, $0.60 $ , per 1 mg ondansetron (Zofran) Q0162 ondansetron 1 mg, oral, FDA-approved prescription antiemetic, for use as a complete therapeutic substitute for an IV antiemetic at the time of chemotherapy treatment, not to exceed a 48-hour dosage regimen see also S0119 $6.01 $0.07 N/A ondansetron (Zofran) S0119 ondansetron, oral, 4 mg (For circumstances falling under the statute, use Q0162.) $24.06 S0119 not payable by palonosetron (Aloxi) J2469 palonosetron hydrochloride, 25 mcg $44.52 $ N/A managedcareoncology.com 31
5 Code Descriptions Code Code Description Immunization administration (includes percutaneous, intradermal, subcutaneous or intramuscular injections); one vaccine (single or combination vaccine/toxoid) (Do not use in conjunction with ) Chemotherapy administration, subcutaneous or intramuscular; nonhormonal antineoplastic Chemotherapy administration, subcutaneous or intramuscular; hormonal antineoplastic Chemotherapy administration, intravenous, push technique; single or initial substance/drug Chemotherapy administration, intravenous infusion technique; up to one hour, single or initial substance/drug Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure.) (Use in conjunction with ) Intravenous infusion, for therapy, prophylaxis or diagnosis (specify substance or drug); initial, up to one hour Intravenous infusion, for therapy, prophylaxis or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure.) (Use in conjunction with 96365, ) Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular Therapeutic, prophylactic or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug Injection, intralesional; up to and including seven lesions Injection, intralesional; more than seven lesions Insertion, nonbiodegradable drug delivery implant Removal, nonbiodegradable drug delivery implant Removal with reinsertion, nonbiodegradable drug delivery implant Arthrocentesis, aspiration and/or injection; small joint or bursa (e.g., fingers, toes) Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow, ankle, olecranon bursa) Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa) Bladder instillation of anticarcinogenic agent (including retention time) References HCPCS Level II Expert Current Procedural Terminology (CPT) American Medical Association. ICD-9-CM for Professionals, Volumes 1 and 2. Chicago: AMA Press RJ Health Systems International, LLC. The Drug Reimbursement Coding and Pricing Guide. Volume 9, Number 2, Second Quarter, FDA-approved indication (product prescribing information). Powered by RJ Health Systems International, LLC, Rocky Hill, Conn. CMS (Centers for & Medicaid Services) -Allowable Second Quarter 2012 Effective Dates. CPT copyright 2012 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. This information was supplied by RJ Health Systems International, LLC, located in Rocky Hill, Conn. Prices and information supplied herein are effective as of April 1, managedcareoncology Quarter
6 Oncology-Related HCPCS Codes This reference chart will assist the Oncology Office (office manager, oncology nurse, physician and ancillary staff) and payor with the appropriate codes to utilize when billing or reimbursing for medication(s). generic (Brand) Name HCPCS Code Code Description FDA-Approved Uses Compendia-Listed Off-Label Uses Current Code Price (AWP-Based Pricing)* Allowable (ASP + 6%)** CPT Admin azacitidine (Vidaza) J9025 azacitidine, 1 mg Myeloid leukemia chronic (205.1_) Low-grade myelodysplastic syndrome lesions (238.72) High-grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) Malignant neoplasm of retroperitoneum and peritoneum specified parts of peritoneum (158.8) Malignant neoplasm of retroperitoneum and peritoneum peritoneum, unspecified (158.9) Malignant neoplasm of pleura (163._) Malignant neoplasm of thymus, heart and mediastinum heart (164.1) Myeloid leukemia acute (205.0_) Hereditary hemolytic anemias other thalassemia (282.49) Sickle-cell disease (282.6_) $6.18 $ cetuximab (Erbitux) J9055 cetuximab, 10 mg Malignant neoplasm of lip (140._) Malignant neoplasm of tongue (141._) Malignant neoplasm of major salivary glands (142._) Malignant neoplasm of gum (143._) Malignant neoplasm of floor of mouth (144._) Malignant neoplasm of other and unspecified parts of mouth (145._) Malignant neoplasm of oropharynx (146._) Malignant neoplasm of nasopharynx (147._) Malignant neoplasm of hypopharynx (148._) Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx (149._) Malignant neoplasm of colon (153._) Malignant neoplasm of rectum, rectosigmoid junction and anus (154._) Malignant neoplasm of nasal cavities, middle ear and accessory sinuses (160._) Malignant neoplasm of larynx (161._) Malignant neoplasm of other and ill-defined sites head, face and neck (195.0) Secondary and unspecified malignant neoplasm of lymph nodes lymph nodes of head, face and neck (196.0) Malignant neoplasm of trachea, bronchus and lung (162._) $59.34 $ managedcareoncology.com 33
7 generic (Brand) Name HCPCS Code Code Description FDA-Approved Uses Compendia-Listed Off-Label Uses Current Code Price (AWP-Based Pricing)* Allowable (ASP + 6%)** CPT Admin clofarabine (Clolar) J9027 clofarabine, 1 mg Lymphoid leukemia acute (204.0_) Myeloid leukemia acute (205.0_) Low-grade myelodysplastic syndrome lesions (238.72) High-grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) $ $ dactinomycin (Cosmegen) J9120 dactinomycin, 0.5 mg Malignant neoplasm of retroperitoneum and peritoneum retroperitoneum (158.0) Malignant neoplasm of bone and articular cartilage (170._) Malignant neoplasm of connective and other soft tissue (171._) Malignant neoplasm of placenta (181) Malignant neoplasm of testis undescended testis (186.0) Malignant neoplasm of testis other and unspecified testis (186.9) Malignant neoplasm of kidney and other and unspecified urinary organs kidney, except pelvis (189.0) Neoplasm of uncertain behavior of genitourinary organs placenta (236.1) Malignant melanoma of skin (172._) Kaposi s sarcoma (176._) Malignant neoplasm of ovary and other uterine adnexa (183._) Malignant neoplasm of other and unspecified female genital organs (184._) Malignant neoplasm of penis and other male genital organs (187._) Malignant neoplasm of eye (190._) Complications of transplanted organ kidney (996.81) Complications of transplanted organ heart (996.83) $ $ decitabine (Dacogen) J0894 decitabine, 1 mg Low-grade myelodysplastic syndrome lesions (238.72) High-grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) Lymphoid leukemia acute (204.0_) Myeloid leukemia acute (205.0_) Myeloid leukemia chronic (205.1_) $39.31 $ degarelix (Firmagon) J9155 degarelix, 1 mg Malignant neoplasm of prostate (185) N/A $6.07 $ managedcareoncology Quarter
8 generic (Brand) Name HCPCS Code Code Description FDA-Approved Uses Compendia-Listed Off-Label Uses Current Code Price (AWP-Based Pricing)* Allowable (ASP + 6%)** CPT Admin melphalan (Alkeran) J9245 melphalan hydrochloride, 50 mg Multiple myeloma and immunoproliferative neoplasms (203. ) Malignant neoplasm of retroperitoneum (158.0) Malignant neoplasm of bone and articular cartilage (170._) Malignant neoplasm of connective and other soft tissue (171._) Malignant melanoma of skin (172._) Malignant neoplasm of female breast (174._) Malignant neoplasm of male breast (175._) Malignant neoplasm of ovary and other uterine adnexa (183._) Malignant neoplasm of other and unspecified female genital organs (184._) Malignant neoplasm of prostate (185) Malignant neoplasm of testis (186._) Malignant neoplasm of penis and other male genital organs (187._) Malignant neoplasm of eye (190._) Hodgkin s disease (201. ) Myeloid leukemia chronic (205.1_) Neoplasm of uncertain behavior of other and unspecified sites and tissues polycythemia vera (238.4) Disorders of plasma protein metabolism macroglobulinemia (273.3) Other and unspecified disorders of metabolism amyloidosis, unspecified (277.30) Other and unspecified disorders of metabolism other amyloidosis (277.39) Other hypertrophic and atrophic conditions of skin other specified hypertrophic and atrophic conditions of skin (701.8) $1, $1, panitumumab (Vectibix) J9303 panitumumab, 10 mg Malignant neoplasm of colon (153._) Malignant neoplasm of rectum, rectosigmoid junction and anus (154._) Malignant neoplasm of trachea, bronchus and lung (162._) $ $ managedcareoncology.com 35
9 generic (Brand) Name HCPCS Code Code Description FDA-Approved Uses Compendia-Listed Off-Label Uses Current Code Price (AWP-Based Pricing)* Allowable (ASP + 6%)** CPT Admin vinorelbine tartrate (Navelbine) J9390 vinorelbine tartrate, per 10 mg Malignant neoplasm of trachea, bronchus and lung (162._) Malignant neoplasm of lip (140._) Malignant neoplasm of tongue (141._) Malignant neoplasm of major salivary glands (142._) Malignant neoplasm of gum (143._) Malignant neoplasm of floor of mouth (144._) Malignant neoplasm of other and unspecified parts of mouth (145._) Malignant neoplasm of oropharynx (146._) Malignant neoplasm of nasopharynx (147._) Malignant neoplasm of hypopharynx (148._) Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx (149._) Malignant neoplasm of esophagus (150._) Malignant neoplasm of retroperitoneum (158.0) Malignant neoplasm of nasal cavities, middle ear and accessory sinuses (160._) Malignant neoplasm of larynx (161._) Malignant neoplasm of connective and other soft tissue (171._) Malignant neoplasm of female breast (174._) Malignant neoplasm of male breast (175._) Kaposi s sarcoma (176._) Malignant neoplasm of cervix uteri (180._) Malignant neoplasm of ovary and other uterine adnexa (183._) Malignant neoplasm of head, face and neck (195.0) Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck (196.0) Lymphosarcoma and reticulosarcoma and other specified malignant tumors of lymphatic tissue (200. ) Hodgkin s disease (201. ) Other malignant neoplasms of lymphoid and histiocytic tissue (202. ) Carcinoma in situ of lip, oral cavity and pharynx (230.0) Carcinoma in situ of esophagus (230.1) Carcinoma in situ of larynx (231.0) Neoplasm of uncertain behavior of connective and other soft tissue (238.1) $32.04 $ *Current code prices are effective as of 4/1/12. The code price is based on the Healthcare Common Procedure Coding System (HCPCS) code description. HCPCS codes are a component of the Centers for & Medicaid Services. The code price is an AWP-based pricing methodology developed by RJ Health Systems International, LLC, Rocky Hill, Conn. **Effective Oncology-Related J-Code References HCPCS Level II Expert Current Procedural Terminology (CPT) American Medical Association. ICD-9-CM for Professionals, Volumes 1 and 2. Chicago: AMA Press Full prescribing information for each drug listed. Powered by RJ Health Systems International, LLC, Rocky Hill, Conn. CMS (Centers for & Medicaid Services) -Allowable Second Quarter Effective Dates 4/1/12-6/30/12. CPT copyright 2012 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. 36 managedcareoncology Quarter
Chapter I Overview Chapter Contents
Chapter I Overview Chapter Contents Table Number Contents I-1 Estimated New Cancer Cases and Deaths for 2005 I-2 53-Year Trends in US Cancer Death Rates I-3 Summary of Changes in Cancer Incidence and Mortality
More informationHydration, IV Infusions, Injections and Vaccine Charge Process
There are a number of items to be considered when billing for the Nursing service to perform drug therapy, the charge process is divided into three specific groups of codes and processes. 1. Hydration
More information190.25 - Alpha-fetoprotein
Other Names/Abbreviations AFP 190.25 - Alpha-fetoprotein Alpha-fetoprotein (AFP) is a polysaccharide found in some carcinomas. It is effective as a biochemical marker for monitoring the response of certain
More informationCHAPTER 2. Neoplasms (C00-D49) March 2014. 2014 MVP Health Care, Inc.
Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs
More informationMeasure Name: Low Back Pain Imaging Studies Measure Code: LBP Lab Data: N
Measure Name: Low Back Pain Imaging Studies Owner: NCQA (LBP) Measure Code: LBP Lab Data: N Rule Description: General Criteria Summary The percentage of patients 18-50 years of age who had a principal
More informationLocal Coverage Article: Drugs and Biologicals - Chemotherapeutic Agents (A52701)
Local Coverage Article: Drugs and Biologicals - Chemotherapeutic Agents (A52701) Contractor Information Contractor Name Cahaba Government Benefit Administrators, LLC Article Information General Information
More informationPET (FDG) Scan for Solid Tumors PET (FDG) SCAN FOR SOLID TUMORS HS-112. Policy Number: HS-112. Original Effective Date: 6/18/2009
Easy Choice Health Plan, Inc. Exactus Pharmacy Solutions, Inc. Harmony Health Plan of Illinois, Inc. Missouri Care, Incorporated WellCare Health Insurance of Arizona, Inc., operating in Hawai i as Ohana
More informationWhat is a Low Back Pain Imaging Tour?
Measure Name: Low Back Pain Imaging Studies Owner: NCQA (LBP) Measure : LBP Lab Data: N Rule : Applicable Provider Specialty: General Criteria Summary The percentage of patients 18-50 years of age who
More informationC a nc e r C e nter. Annual Registry Report
C a nc e r C e nter Annual Registry Report 214 214 Cancer Registry Report Larraine A. Tooker, CTR Please note that the 214 Cancer Registry Annual Report is created in 214, but it reflects data on cases
More informationHospital-Based Tumor Registry. Srinagarind Hospital, Khon Kaen University
Hospital-Based Tumor Registry Srinagarind Hospital, Khon Kaen University Statistical Report 2012 Cancer Unit, Faculty of Medicine Khon Kaen University Khon Kaen, Thailand Tel & Fax:+66(43)-202485 E-mail:
More informationNEOPLASMS C00 D49. Presented by Jan Halloran CCS
NEOPLASMS C00 D49 Presented by Jan Halloran CCS 1 INTRODUCTION A neoplasm is a new or abnormal growth. In the ICD-10-CM classification system, neoplastic disease is classified in categories C00 through
More informationDELRAY MEDICAL CENTER. Cancer Program Annual Report
DELRAY MEDICAL CENTER Cancer Program Annual Report Cancer Statistical Data From 2010 TABLE OF CONTENTS Chairman s Report....3 Tumor Registry Statistical Report Summary...4-11 Lung Study.12-17 Definitions
More informationThe effect of the introduction of ICD-10 on cancer mortality trends in England and Wales
The effect of the introduction of ICD-10 on cancer mortality trends in Anita Brock, Clare Griffiths and Cleo Rooney, Offi ce for INTRODUCTION From January 2001 deaths in have been coded to the Tenth Revision
More informationMOH Policy for dispensing NEOPLASTIC DISEASES DRUGS
MOH Policy for dispensing NEOPLASTIC DISEASES DRUGS All prescriptions for antineoplastic drugs must be accompanied by the MOH special form. All the attachments mentioned on this form shall be submitted
More informationENTERAL NUTRITION Policy/CPT ICD-10 ICD-10 Description ICD-9 ICD-9 Description EPA 870001100 N18.6 End stage renal disease 585.
ENTERAL NUTRITION Policy/CPT ICD-10 ICD-10 Description ICD-9 ICD-9 Description EPA 870001100 N18.6 End stage renal disease 585.6 End stage renal disease EPA 870001101 C00.0 Malignant neoplasm of external
More informationTHE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS
THE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS Northside Medical Center Cancer Committee Mission Statement It is the mission of the Cancer Committee to evaluate and monitor the care of
More informationDescription Code Recommendation Description Code. All natural death 001-799 IPH All natural death A00-R99
Natural death Description Code Recommendation Description Code All natural death 001-799 IPH All natural death A00-R99 Infectious and parasitic diseases 001-139 CDC, EUROSTAT, CBS & VG Infectious and parasitic
More informationTable 2.2. Cohort studies of consumption of alcoholic beverages and cancer in special populations
North America Canada Canadian 1951 Schmidt & Popham (1981) 1951 70 9 889 alcoholic men, aged 15 years, admitted to the clinical service of the Addiction Research Foundation of Ontario between Death records
More informationNumber. Source: Vital Records, M CDPH
Epidemiology of Cancer in Department of Public Health Revised April 212 Introduction The general public is very concerned about cancer in the community. Many residents believe that cancer rates are high
More informationPreventing and Treating Nausea and Vomiting Caused by Cancer Treatment
A Patient s Guide Preventing and Treating Nausea and Vomiting Caused by Cancer Treatment Recommendations of the American Society of Clinical Oncology The American Society of Clinical Oncology (ASCO) is
More informationTreatment of Hepatic Neoplasm
I. Policy University Health Alliance (UHA) will reimburse for treatment of hepatic neoplasm outside of systemic chemotherapy alone when determined to be medically necessary and within the medical criteria
More informationCost Differences in Cancer Care Across Settings
Cost Differences in Cancer Care Across Settings August 2013 THE MORAN COMPANY 1 Cost Differences in Cancer Care Across Settings In a prior memorandum, we presented evidence documenting the growing share
More informationREPORTABLE NEOPLASMS. Reportable List
to Based on FY2014 codes REPORTABLE NEOPLASMS and subcategory codes are shaded in grey and marked with an ^ Cells shaded in pink and marked with an *indicate the preferred code when a single code maps
More informationPhone: 1-877-336-3736 Fax: 1-877-556-3737 M F 8:00 am 9:00 pm ET
QUICK REFERENCE CODING & BILLING GUIDE PHYSICIAN OFFICE CMS National Coverage Determination and Q-Code for PROVENGE Simplifies patient coverage criteria Clarifies coding requirements Expedites electronic
More informationLinks in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Jurisdiction Virginia. Retirement Date N/A
Local Coverage Determination (LCD): Computerized Axial Tomography of the Chest/Thorax (L34416) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor
More informationPage 1 of 6 Origination Date: 08/13 Revision Date(s): 12/13, 12/14, 04/2015 Developed By: Medical Criteria Committee Effective Date: 10/1/2013
Moda Health Plan, Inc. Medical Necessity Criteria Subject: Alimta (pemetrexed) Page 1 of 6 Origination Date: 08/13 Revision Date(s): 12/13, 12/14, 04/2015 Developed By: Medical Criteria Committee Effective
More informationPediatric Oncology for Otolaryngologists
Pediatric Oncology for Otolaryngologists Frederick S. Huang, M.D. Division of Hematology/Oncology Department of Pediatrics The University of Texas Medical Branch Grand Rounds Presentation to Department
More informationCancercare Connect Booklet Series. Renal Cell Cancer. www.cancercare.org
Cancercare Connect Booklet Series Treatment Update Renal Cell Cancer www.cancercare.org Treatment Update Renal Cell Cancer Table of Contents The CancerCare Connect Booklet Series offers up-to-date, easy-to-read
More informationCancer in Northeastern Pennsylvania: Incidence and Mortality of Common Cancers
Cancer in Northeastern Pennsylvania: Incidence and Mortality of Common Cancers Samuel M. Lesko, MD, MPH Medical Director Karen Ryczak, RN Surveillance Coordinator November 2015 334 Jefferson Avenue, Scranton,
More informationCancer Conferences 2008
2009 Annual Report Cancer Registry Report The Cancer Registry collects data on all cancer patients who were diagnosed and/or treated at East Alabama Medical Center. Diagnostic, therapeutic and outcome
More informationMedications most likely to be seen in primary care
Hazardous Medicines The majority of medicines are not classed as hazardous. The only medicinal products that are automatically deemed to be hazardous are cytotoxic and cytostatic medicines. There is no
More informationLCD for Prostate Specific Antigen (PSA)
LCD for Prostate Specific Antigen (PSA) Applicable CPT Code(s): 84152 Prostate Specific Antigen (PSA); Complexed (Direct Measurement) 84153 Prostate Specific Antigen (PSA); Total 84154 Prostate Specific
More informationAnalysis of Costs Associated With Administration of Intravenous Single-Drug Therapies in Metastatic Breast Cancer in a U.S.
RESEARCH Analysis of Associated With Administration of Intravenous Single-Drug Therapies Gregory B. Kruse, MPH, MSc; Mayur M. Amonkar, PhD; Gregory Smith, BA; Dean C. Skonieczny, MBA, BSE; and Spyros Stavrakas,
More informationR E X C A N C E R C E N T E R. Annual Report 2012. Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care
R E X C A N C E R C E N T E R Annual Report 2012 Rex Cancer Care Committee 2012 On behalf of the Rex Cancer Center & Rex Health Care An American College of Surgeons Commission on Cancer Accredited Comprehensive
More informationCANCER COMMITTEE MEMBERS NORTHWESTERN LAKE FOREST HOSPITAL\ 2010
CANCER COMMITTEE MEMBERS NORTHWESTERN LAKE FOREST HOSPITAL\ 2010 Michael Cochran, MD Susan Balling R.N. Karline Peal RT Stephen Ganshirt M.D. Nancy Bulzoni Emily Rosecrans Joseph Imperato M.D Linda Dickson
More informationMMA - 2005 Drug Administration Coding Revisions
Related Change Request (CR) #: 3631 Related CR Release Date: December 10, 2004 Related CR Transmittal #: 129 Effective Date: January 1, 2005 Implementation Date: January 17, 2005 MMA - 2005 Drug Administration
More informationLocal Coverage Determination (LCD): Immunohistochemistry (L34369)
Local Coverage Determination (LCD): Immunohistochemistry (L34369) Contractor Information Contractor Name CGS Administrators, LLC LCD Information Document Information LCD ID L34369 Original ICD9 LCD ID
More informationORGAN SYSTEMS OF THE BODY
ORGAN SYSTEMS OF THE BODY DEFINITIONS AND CONCEPTS A. Organ a structure made up of two or more kinds of tissues organized in such a way that they can together perform a more complex function that can any
More informationNon-covered ICD-10-CM Codes for All Lab NCDs
Non-covered ICD-10-CM s for All Lab NCDs This section lists codes that are never covered by Medicare for a diagnostic lab testing service. If a code from this section is given as the reason for the test,
More informationMEDICAL MANAGEMENT POLICY
TITLE: Scar Revision/Keloid PAGE: 1of 9 This Medical policy is not a guarantee of benefits or coverage, nor should it be deemed as medical advice. In the event of any conflict concerning benefit coverage,
More informationPhysician Coding and Payment Guide 2015
Targeted Drug Delivery Physician Coding and Payment Guide 2015 Flowonix Medical has compiled this coding information for your convenience. This information is gathered from third party sources and is subject
More informationAmbulatory Surgery Center Coding and Payment Guide 2015
Targeted Drug Delivery Ambulatory Surgery Center Coding and Payment Guide 2015 Flowonix Medical has compiled this coding information for your convenience. This information is gathered from third party
More informationLocal Coverage Determination (LCD): Erythropoiesis Stimulating Agents (L29168)
Home About CMS Newsroom Center FAQs Archive Share Help Email Print Learn about your healthcare options Medicare Medicaid/CHIP Medicare-Medicaid Coordination Private Insurance Innovation Center Regulations
More informationTotal Cost of Cancer Care by Site of Service: Physician Office vs Outpatient Hospital
Total Cost of Cancer Care by Site of Service: Physician Office vs Outpatient Hospital Prepared by Avalere Health, LLC Page 2 Executive Summary Avalere Health analyzed three years of commercial health plan
More informationCarcinoma of the vagina is a relatively uncommon disease, affecting only about 2,000 women in
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition, 2001 Vagina Jeffrey L. Stern, MD Carcinoma of the vagina is
More informationReimbursement for Physician- Administered Drugs:
Reimbursement for Physician- Purchased and Physician- Administered Drugs: Understanding the Buy and Bill Process 60889-R5-V1 This information is provided d for your background education and is not intended
More informationDocumentation Summary for Chemotherapy Administration, Nonchemotherapy Injections and Infusions
Documentation Summary for Chemotherapy Administration, Nonchemotherapy Injections and Infusions Documentation to Support Medical Necessity of Chemotherapy Services Date: April 23, 2012 Source Information:
More informationAvastin: Glossary of key terms
Avastin: Glossary of key terms Adenocarcinoma Adenoma Adjuvant therapy Angiogenesis Anti-angiogenics Antibody Antigen Avastin (bevacizumab) Benign A form of carcinoma that originates in glandular tissue.
More informationChemotherapy Administration, Hydration and Therapeutic, Prophylactic, and Diagnostic Injections and Infusions
Chemotherapy Administration, Hydration and Therapeutic, Prophylactic, and Diagnostic Injections and Infusions Table of Contents: Overview... Professional Services... 2 Services... 4 Overview Chemotherapy
More informationNational Coverage Determination (NCD) for Tumor Antigen by Immunoassay - CA 125 (190.28)
National Coverage Determination (NCD) for Tumor Antigen by Immunoassay - CA 125 (190.28) Tracking Information Publication Number Manual Section Number 100-3 190.28 Manual Section Title Tumor Antigen by
More informationCancer in Norway 2008
Cancer in Norway 8 Cancer incidence, mortality, survival and prevalence in Norway Special issue: The Janus Serum Bank From sample collection to cancer research Cancer in Norway 8 Editor-in-chief: Freddie
More informationReimbursement Billing and Coding Guide
Reimbursement Billing and Coding Guide Please see Indication and Important Safety Information on page 2 and 3 This billing guide is intended to provide healthcare providers with an overview of coding,
More informationMedicare Part B. Mammograms - Updated Billing Guide for Screening and Diagnostic Tests
Mammograms - Updated Billing Guide for Screening and Diagnostic Tests This article from Medicare B News Issue 223 dated October 21, 2005 is being updated and reprinted to ensure that the Noridian Administrative
More informationStem Cell Transplantation
Harmony Behavioral Health, Inc. Harmony Behavioral Health of Florida, Inc. Harmony Health Plan of Illinois, Inc. HealthEase of Florida, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance
More informationMASCC/ESMO Antiemetic Guideline 2013
MASCC/ESMO Antiemetic Guideline 2013 Multinational Association of Supportive Care in Cancer Organizing and Overall Meeting Chairs: Richard J. Gralla, MD Fausto Roila, MD Maurizio Tonato, MD Jørn Herrstedt,
More informationCMS Limitations Guide Mammograms and Bone Density Radiology Services
CMS Limitations Guide Mammograms and Bone Density Radiology Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with
More informationMedStar Montgomery Medical Center. Cancer Center 2014 Annual Report
MedStar Montgomery Medical Center Cancer Center 2014 Annual Report 2014 MedStar Montgomery Medical Center Cancer Center Committee Report Cancer Committee Chair s Report According to a recent report from
More informationWorld Trade Center Health Program; Addition of Certain Types of Cancer to the List of WTC-Related Health Conditions
This document is scheduled to be published in the Federal Register on 09/12/2012 and available online at http://federalregister.gov/a/2012-22304, and on FDsys.gov BILLING CODE: 4163-18-P DEPARTMENT OF
More informationHow To Treat A Uterine Sarcoma
EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition 2001 Uterus: Uterine Sarcomas Jeffrey L. Stern, MD Uterine sarcomas
More informationDiagnosis and Treatment of Common Oral Lesions Causing Pain
Diagnosis and Treatment of Common Oral Lesions Causing Pain John D. McDowell, DDS, MS University of Colorado School of Dentistry Chair, Oral Diagnosis, Medicine and Radiology Director, Oral Medicine and
More informationReimbursement BILLING GUIDE
Reimbursement BILLING GUIDE Merck has developed this Reimbursement Billing Guide as a tool to help you navigate the health care insurance environment for KEYTRUDA. IMPORTANT INFORMATION CONTENTS The information
More informationLocal Coverage Determination (LCD): Erythropoietin Stimulating Agents (ESA) (L34165)
Centers for Medicare & Medicaid Services < Return to Previous Page Print Message: If you are experiencing issues printing this page, then please click Return to Previous Page and select the 'Need a PDF?'
More informationSecond Cancers in Adults
Second Cancers in Adults This document focuses on second cancers in adults. For information about second cancers after treatment of childhood cancers, see our document Children Diagnosed With Cancer: Late
More informationCorporate Medical Policy
Corporate Medical Policy Intensity Modulated Radiation Therapy (IMRT) of Head and Neck File Name: Origination: Last CAP Review: Next CAP Review: Last Review: intensity_modulated_radiation_therapy_imrt_of_head_and_neck
More informationCHAPTER 6: TREATMENT FOR SMALL CELL LUNG CANCER
CHAPTER 6: TREATMENT FOR SMALL CELL LUNG CANCER INTRODUCTION This chapter provides an overview of treatment for small cell lung cancer (SCLC). Treatment options are presented based on the extent of disease.
More informationAcute Myeloid Leukemia
Acute Myeloid Leukemia Introduction Leukemia is cancer of the white blood cells. The increased number of these cells leads to overcrowding of healthy blood cells. As a result, the healthy cells are not
More informationReport series: General cancer information
Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for
More informationEstimated New Cases of Leukemia, Lymphoma, Myeloma 2014
ABOUT BLOOD CANCERS Leukemia, Hodgkin lymphoma (HL), non-hodgkin lymphoma (NHL), myeloma, myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) are types of cancer that can affect the
More informationSAMPLE. Anesthesia Services. An essential coding, billing, and reimbursement resource for anesthesiology and pain management ICD-10
Coding and Payment Guide www.optumcoding.com Anesthesia Services An essential coding, billing, and reimbursement resource for anesthesiology and pain management 2017 a ICD10 A full suite of resources including
More informationPathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes
Pathology ICD-10-CM Coding Tip Sheet Overview of Key Chapter Updates for Pathology and Top 25 codes Chapter 2 Neoplasms (C00-D49) Classification improvements Code expansions Significant expansions or revisions
More informationBilling Guideline. Subject: Colorectal Cancer Screening Exams (Invasive Procedures) Effective Date: 1/1/2012 Last Update Effective: 4/16
Subject: Colorectal Cancer Screening Exams (Invasive Procedures) Effective Date: 1/1/2012 Last Update Effective: 4/16 Billing Guideline Background Health First administers benefit packages with full coverage
More informationCancer Surgery Volume Study: ICD-9 and CPT Codes
This paper contains the ICD-9 diagnostic and procedure codes and the CPT procedure codes used by researchers for a project of the California HealthCare Foundation (CHCF) and the California Office of Statewide
More informationCorrect Coding for Infusions and Injections. Agenda. Supervision Levels. Regan Tyler, CPC, CPC-H, CPMA, CEMC, ACS-EM
Correct Coding for Infusions and Injections Regan Tyler, CPC, CPC-H, CPMA, CEMC, ACS-EM 1 Agenda The hierarchy facility vs. clinic for infusion coding - Initial, each additional, each sequential, concurrent
More information2011 ANNUAL REPORT C.H. Chub O Reilly Cancer Center. The cancer journey
2011 ANNUAL REPORT C.H. Chub O Reilly Cancer Center The cancer journey The C.H. Chub O Reilly Cancer Center is home to the latest technology and treatments, including davinci surgery, the region s only
More informationSMALL. 1-800-298-2436 LungCancerAlliance.org
Understanding series SMALL CELL LUNG CANCER 1-800-298-2436 LungCancerAlliance.org A guide for the patient I TABLE OF CONTENTS ANATOMY OF THE LUNGS The following image shows different parts that make up
More informationThe Ontario Cancer Registry moves to the 21 st Century
The Ontario Cancer Registry moves to the 21 st Century Rebuilding the OCR Public Health Ontario Grand Rounds Oct. 14, 2014 Diane Nishri, MSc Mary Jane King, MPH, CTR Outline 1. What is the Ontario Cancer
More informationDrug treatments for kidney cancer
James Whale Fund for Kidney Cancer Drug treatments for kidney cancer Before your doctors can discuss treatment options with you they need to know how far your cancer has progressed. Staging is used to
More informationHEALTH DEPARTMENT BILLING GUIDELINES
HEALTH DEPARTMENT BILLING GUIDELINES Acknowledgement: Current Procedural Terminology (CPT ) is copyright 2015 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative
More informationThis module consists of four units which will provide the user a basic knowledge of cancer as a disease.
Module 5: What is Cancer? This module consists of four units which will provide the user a basic knowledge of cancer as a disease. After completing this module, cancer abstractors will be able to: Define
More informationAPPENDIX: CHEMOTHERAPY SIDE EFFECT PROFILES
APPENDIX: CHEMOTHERAPY SIDE EFFECT PROFILES All chemotherapy drugs can cause side effects. No one can predict ahead of time what side effects you may experience or their severity. Some people experience
More informationTreatment Part Two 1 FLORIDA CANCER DATA SYSTEM Treatment - Part Two
Treatment Part Two 1 Prerequisites 2 Completion of FCDS, Introduction to Abstracting module Completion of FCDS, Treatment Part One Learning Objectives 3 Recognize cancer treatment modalities Acquire a
More informationNCI Community Cancer Centers Program Program Overview Ascension Health St. Vincent Indianapolis Hospital
A. Name and location of hospital:, Indianapolis, IN B. Name of cancer center: St. Vincent Oncology Center C. Identify PI and key personnel with contact information for each pilot focus areas: a. Disparities
More informationNew Hampshire Childhood Cancer
Introduction: New Hampshire Childhood Cancer New Hampshire, Childhood Cancer, January 2009 Issue Brief Cancer in children is relatively uncommon, impacting fewer than twenty two of every 100,000 children
More informationHospital Outpatient Coding and Billing Information Sheet for Neulasta and NEUPOGEN
Hospital Outpatient Coding and Billing Information Sheet for Neulasta and Neulasta Delivery Kit Neulasta Prefilled Syringe For assistance contact 1-844-MYNEULASTA (1-844-696-3852) or visit www.amgenassistonline.com
More informationEliminating Infusion Confusion. Agenda
Eliminating Infusion Confusion (Drug Administrations in Facility and Non-facility Settings) Presented by Maria Rita Genovese, CPC, PCS & Maryann C. Palmeter, CPC, CENTC 1 Agenda Review of CPT codes What
More informationMODERN IMMUNOHISTOCHEMISTRY
MODERN IMMUNOHISTOCHEMISTRY Cambridge Illustrated Surgical Pathology Peiguo G. Chu City of Hope National Medical Center, Duarte, California Lawrence M. Weiss City of Hope National Medical Center, Duarte,
More informationCancer Center Annual Report. Troy & Dollie Smith Cancer Center INTEGRIS Baptist Medical Center
2007 Cancer Center Annual Report with statistical data from 2006 Troy & Dollie Smith Cancer Center Medical Center Medical Center 2007 Cancer Committee Physician Members CO-CHAIRMAN James W. Hampton, M.D.,
More informationMultiple Primary and Histology Coding Rules
Multiple Primary and Histology Coding Rules January 10, 2008 National Cancer Institute Surveillance Epidemiology and End Results Program Bethesda, MD PLEASE NOTE This PDF of the 2007 Multiple Primaries
More informationHow To Know If You Have Cancer At Mercy Regional Medical Center
MERCY REGIONAL CANCER CENTER 2012 CANCER PROGRAM ANNUAL REPORT Using 2011 Data Mercy Regional Cancer Center When you have cancer, you might think first of treatments chemotherapy and radiation. You want
More informationOctober is Breast Cancer Awareness Month!
October is Breast Cancer Awareness Month! A STUDY OF CHARACTERISTICS AND MANAGEMENT OF BREAST CANCER IN TAIWAN Eric Kam-Chuan Lau, OMS II a, Jim Yu, OMSII a, Christabel Moy, OMSII a, Jian Ming Chen, MD
More informationPHYSICIAN OFFICE BILLING INFORMATION SHEET FOR IMLYGIC (talimogene laherparepvec)
PHYSICIAN OFFICE BILLING INFORMATION SHEET FOR IMLYGIC (talimogene laherparepvec) INDICATION IMLYGIC is a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable
More informationBIO 137: CHAPTER 1 OBJECTIVES
BIO 137: CHAPTER 1 OBJECTIVES 1. Define the terms anatomy and physiology, and explain their relationship using an example of a human structure with its corresponding function. A. ANATOMY = the study of
More informationLTC Pharmacy Setting B/D Coverage. Because most LTC facilities are not considered a beneficiary s home 3
Medicare Parts Issues This table provides a reference guide for the most frequent B/D coverage determination scenarios facing Part D plans and Part D pharmacy providers. It does not address all potential.
More informationFeline Lymphoma Chemotherapy and Chemotherapy Protocols
Feline Lymphoma Chemotherapy and Chemotherapy Protocols If you have reached this page, your cat probably has a definite diagnosis of feline lymphoma from your veterinarian. The information below is not
More informationCoding Trends for Infusions and Injections. Injections
Coding Trends for Infusions and Injections Lynn M. Anderanin, CPC,CPC I,COSC AHIMA Approved ICD 10 CM Trainer 1 Today s Agenda Infusions Injections Drugs 2 1 Infusions 3 categories of CPT codes for chemotherapy
More informationThe Cancer Center of Chester County Annual Report 2006 With statistical data from 2005
06 The Cancer Center of Chester County Annual Report 2006 With statistical data from 2005 2005 Statistical Report Community Screenings Screening Participants Normal Results Referred for Follow-up Colon
More informationBreastCancerTrials.org History Form: Metastatic Breast Cancer ABOUT ME
BreastCancerTrials.org History Form: Metastatic Breast Cancer This form is for patients with metastatic breast cancer who were: Were recently diagnosed with metastatic breast cancer (cancer that has spread
More informationBreast Cancer. Breast Cancer Page 1
Breast Cancer Summary Breast cancers which are detected early are curable by local treatments. The initial surgery will give the most information about the cancer; such as size or whether the glands (or
More informationOncology Annual Report 2014
Oncology Annual Report 2014 Cancer Committee Chairman Report 2014 A Year of Patient Care Improvements The Gwinnett Medical Center Cancer Institute has quite a bit to be proud of this year. The Cancer Support
More information