Idea Transcript
Drug & Administration
compendia
Treatment of
Ovarian Cancer This section will address such topics as: With each publication, Managed Care Oncology’s Drug & Administration Compendia will highlight a single medication or a group of medications that could be utilized in the management of one of the featured oncology diseases.
• Associated ICD-9-CM Codes (includes FDA-approved1 and Compendia- approved2 indications) • Possible medication(s) used to treat the conditions; including ancillary medication(s) • Reimbursement and coding information (How to bill for new medications)
– HCPCS/CPT Codes and Code Description – Current Code Price (AWP-based pricing) – Most recent Medicare-Allowable (ASP+6%) – Possible CPT Administration Codes that can be utilized with each medication
Associated ICD-9-CM Codes: 183 Malignant neoplasm of ovary and other uterine adnexa Excludes: Douglas’ cul-de-sac (158.8) – 183.0 Ovary Use additional code to identify any functional activity – 183.2 Fallopian tube Oviduct Uterine tube – 183.3 Broad ligament Mesovarium Parovarian region
– 183.4 Parametrium Uterine ligament NOS Uterosacral ligament – 183.5 Round ligament – 183.8 Other specified sites of uterine adnexa Tubo-ovarian Utero-ovarian Malignant neoplasm of contiguous or overlapping sites of ovary and other uterine adnexa whose point of origin cannot be determined – 183.9 Uterine adnexa, unspecified
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Medications Currently Available to Treat Ovarian Cancer Include: HCPCS Code/generic (Brand) Name
Code Description
Current Code Price Effective Date
Current Code Price (AWPbased pricing)
MedicareAllowable (ASP+6%) – Effective 10/1/0812/31/08
CPT Administration Code(s)
HCPCS Code/generic (Brand) Name
Code Description
Current Code Price Effective Date
Current Code Price (AWPbased pricing)
MedicareAllowable (ASP+6%) – Effective 10/1/0812/31/08
CPT Administration Code(s)
J9190 fluorouracil (Adrucil)2
Fluorouracil, 500 mg
7/1/2007
$3.44
$1.68
96409
J9201 gemcitabine HCl (Gemzar)1
Gemcitabine HCl, 200 mg
8/1/2008
$168.21
$135.08
96413
J9206 irinotecan (Camptosar)2
Irinotecan, 20 mg
8/1/2008
$32.82
$37.00
96413, 96415
J9208 ifosfamide (Ifex)2
Ifosfamide, 1 g
9/1/2008
$58.75
$33.80
96413, 96415
J9250 methotrexate sodium2
Methotrexate sodium, 5 mg
11/1/2007
$0.24
$0.22
90772, 90774, 96401, 96409, 96450
J9260 methotrexate sodium2
Methotrexate sodium, 50 mg
11/1/2007
$2.38
$2.36
90772, 90774, 96401, 96409, 96450
J9265 paclitaxel (Onxol, Taxol)1
Paclitaxel, 30 mg
8/1/2008
$22.85
$11.04
96413, 96415
J0207 amifostine (Ethyol)2
Injection, amifostine, 500 mg
6/1/2008
$564.95
$424.03
90774
J8530 cyclophosphamide (Cytoxan)1
Cyclophosphamide, oral, 25 mg
9/1/2006
$2.03
$0.91
N/A
J8560 etoposide (VePesid)2
Etoposide, oral, 50 mg
11/1/2001
$47.64
$29.35
N/A
J8600 melphalan (Alkeran)1
Melphalan, oral, 2 mg
3/1/2008
$5.63
$2.32
N/A
J8610 methotrexate2
Methotrexate, oral, 2.5 mg
9/10/2003
$3.56
$0.16
N/A
J9000 doxorubicin HCl (Adriamycin)1
Doxorubicin HCl, 10 mg
8/7/2003
$13.75
$4.66
96409
J9001 doxorubicin HCl (Doxil)1
Doxorubicin HCI, all lipid formulations, 10 mg
8/1/2008
$546.50
$429.51
96413
J9045 carboplatin (Paraplatin)1
Carboplatin, 50 mg
3/1/2008
$52.55
$9.61
96413, 96415
J9340 thiotepa (Thioplex)1
Thiotepa, 15 mg
8/1/2008
$123.13
$94.54
96409, 51720
J9060 cisplatin (Platinol AQ)1
Cisplatin, powder or solution, per 10 mg
1/1/2008
$4.57
$2.30
96413, 96415
J9350 topotecan (Hycamtin)1
Topotecan, 4 mg
10/1/2008
$1,199.73
$930.67
96413
J9062 cisplatin (Platinol AQ)1
Cisplatin, 50 mg
1/1/2008
$22.85
$11.52
96413, 96415
J9390 vinorelbine tartrate (Navelbine)2
Vinorelbine tartrate, per 10 mg
10/1/2008
$44.38
$16.57
96409
J9090 cyclophosphamide (Cytoxan)1
Cyclophosphamide, 500 mg
10/1/2008
$31.60
$10.80
96409, 96413, 96415
S0172 chlorambucil (Leukeran)2
Chlorambucil, oral, 2 mg
10/1/2008
$3.36
N/A – see NDC level pricing below
N/A
J9091 cyclophosphamide (Cytoxan)1
Cyclophosphamide, 1.0 gm
5/1/2008
$28.88
$21.61
96409, 96413, 96415
S0176 hydroxyurea (Hydrea)1
Hydroxyurea, oral, 500 mg
1/1/2002
$1.28
N/A – see NDC level pricing below
N/A
J9092 cyclophosphamide (Cytoxan)1
Cyclophosphamide, 2.0 gm
5/1/2008
$52.50
$43.21
96409, 96413, 96415
J9170 docetaxel (Taxotere)2
Docetaxel, 20 mg
8/1/2008
$445.86
$334.64
96413
J9178 epirubicin HCl (Ellence)2
Injection, epirubicin HCl, 2 mg
8/1/2008
$9.88
$5.45
96409, 96413
J9181 etoposide (Toposar)2
Etoposide, 10 mg
8/1/2007
$0.55
$0.49
96413, 96415
J9182 etoposide (Toposar)2
Etoposide, 100 mg
8/1/2007
$5.50
$4.84
96413, 96415
Additional Non-Classified Medications Available to Treat Ovarian Cancer: (These medications have not been assigned a permanent HCPCS J-Code by CMS)
30 managedcareoncology Quarter 4 2008
J8999: Prescription drug, oral, chemotherapeutic, Not Otherwise Specified** generic (Brand) Name/Strength
NDC (National Drug Code)
AWP Effective Date
AWP/unit
Medicare- Allowable (WAC or WAC + 106%) – Effective 10/1/08-12/31/08
CPT Administration Code(s)
altretamine (Hexalen) 1/50 mg
58063-000170
8/26/2008
$12.29/cap
$9.83/cap
N/A
chlorambucil (Leukeran) 2/2 mg
00173-063535
9/3/2008
$3.36/tab
$2.69/tab
N/A
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Additional Non-Classified Medications Available to Treat Ovarian Cancer: (These medications have not been assigned a permanent HCPCS J-Code by CMS) J8999: Prescription drug, oral, chemotherapeutic, Not Otherwise Specified** generic (Brand) Name/Strength hydroxyurea (Hydrea) 1/500 mg
NDC (National Drug Code) 00003-083050
AWP Effective Date 9/5/2008
AWP/unit
$1.52/cap
Medicare- Allowable (WAC or WAC + 106%) – Effective 10/1/08-12/31/08
CPT Administration Code(s)
$1.22/cap
N/A
HCPCS Code/ generic (Brand Name
Code Description
Current Code Price (AWP- based pricing)
MedicareAllowable (ASP+6%) – Effective 10/1/0812/31/08
CPT Administration Code(s)
J1626 granisetron (Kytril)
Injection, granisetron HCI, 100 mcg
10/1/2008
$10.61
$4.33
90774
J2405 ondansetron (Zofran)
Injection, ondansetron HCI, per 1 mg
5/1/2008
$0.63
$0.19
90772, 90774
J2469 palonosetron (Aloxi)
Injection, palonosetron HCl, 25 mcg
10/1/2008
$41.50
$16.45
90774
J8501
Aprepitant, oral, 5 mg 9/1/2007
$6.60
$5.34
N/A
5/1/2008 Granisetron HCI, 1mg oral, FDAapproved prescription anti-emetic, for use as a complete therapeutic substitute for an IV antiemetic at time of chemotherapy treatment, not to exceed a 24-hour dosage regimen
$59.00
$17.88
N/A
aprepitant (Emend)
Q0166 granisetron (Kytril)
CPT Administration Code(s)
$39.33
$3.94
N/A
S0091 granisetron (Kytril)
5/1/2008 Granisetron HCI, 1 mg (for circumstances falling under the Medicare statute, use Q0166)
$59.00
N/A
N/A
S0181 ondansetron (Zofran)
Ondansetron HCl, oral, 4 mg (for circumstances falling under the Medicare statute, use Q0179)
7/1/2008
$23.98
N/A
N/A
CPT Administration Code Descriptions CPT Administration Code
32 managedcareoncology Quarter 4 2008
MedicareAllowable (ASP+6%) – Effective 10/1/0812/31/08
7/1/2008 Ondansetron HCI 8mg, oral, FDAapproved prescription anti-emetic, for use as a complete therapeutic substitute for an IV antiemetic at time of chemotherapy treatment, not to exceed a 48-hour dosage regimen (Code price is per 8 mg)
Ancillary Medications Used in Cancer Treatment Current Code Price Effective Date
Current Code Price (AWP- based pricing)
Q0179 ondansetron (Zofran)
** When billing a non-classified medication using a CMS 1500 claim form you must include both the HCPCS code (e.g., J8999 for Leukeran) in Column 24D and the drug name, strength, and NDC (National Drug Code) in Box 19 in order to ensure appropriate reimbursement.
HCPCS Code/ generic (Brand Name
Code Description
Current Code Price Effective Date
Code Description
96401
Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
96402
Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
96409
Chemotherapy administration; intravenous, push technique, single or initial substance/drug
96411
Chemotherapy administration; intravenous, push technique, each additional substance/drug (List separately in addition to code for primary procedure) (Use 96411 in conjunction with 96409 and 96413)
96413
Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415
Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure) (Use 96415 in conjunction with 96413)
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CPT Administration Code Descriptions CPT Administration Code
Code Description
96416
Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump
96417
Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure) (Use 96417 in conjunction with 96413)
96450
Chemotherapy administration, into CNS (e.g., intrathecal), requiring and including spinal puncture
90765
Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
90772
Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
90774
Therapeutic, prophylactic or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug
11981
Insertion, nonbiodegradable drug delivery implant
11982
Removal, nonbiodegradable drug delivery implant
11983
Removal with reinsertion, non-biodegradable drug delivery implant
51720
Bladder instillation of anticarcinogenic agent (including retention time)
HCPCS Code/ generic (Brand) Name
Code Description
FDA-Approved Uses
Anemia in chronic kidney disease (285.21) Anemia in neoplastic disease (285.22) Anemia, unspecified (285.9) Encounter for antineoplastic chemotherapy (V58.11)
Anemia of other chronic disease (285.29) Essential thrombocythemia (238.71) 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) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79)
$15.31 9/1/2008
$9.10
90772 90774
J0894 decitabine (Dacogen)
Injection, 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)
Myeloid leukemia – Acute (205.0)
$32.88 10/1/2008
$27.83
96413 96415
Oncology-Related HCPCS Codes
HCPCS Code/ generic (Brand) Name
J0881 darbepoetin alfa (Aranesp)
Code Description
Injection, darbepoetin alfa, 1 mcg (non-ESRD use)
FDA-Approved Uses
Anemia in chronic kidney disease (285.21) Anemia in neoplastic disease (285.22) Anemia, unspecified (285.9) Encounter for antineoplastic chemotherapy (V58.11)
34 managedcareoncology Quarter 4 2008
Compendia-Approved Uses
N/A
Code Price**/ Effective Date $6.02 9/1/2008
CPT Admin Code(s)
$2.96
90772
CPT Admin Code(s)
Injection, epoetin alfa, (for nonESRD use), 1000 units
• HCPCS Level II Expert 2008 • Current Procedural Terminology (CPT®) 2008 • 2008 MMI ICD-9-CM Volumes 1 & 2 Professional for Physicians • The Drug Reimbursement Coding and Pricing Guide by R_J Health Systems International, LLC, Volume 5, Number 4, 4th Quarter 2008 • 1 FDA-approved indication (Product prescribing information) • 2 Compendia-approved indication (DRUGDEX® by Thomson Reuters and Association of Community Cancer Centers’ Compendia-Based Drug Bulletin, May 2008) • www.ReimbursementCodes.com powered by R_J Health Systems International, LLC, Wethersfield, CT • CMS (Centers for Medicare and Medicaid Services) – Medicare-Allowable 4th Quarter 2008 – Effective Dates 10/1/08–12/31/08 This information was supplied by R_J Health Systems International, LLC located in Wethersfield, Connecticut. Prices listed herein are effective as of October 1, 2008.
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08
J0885 epoetin alfa (Procrit, Epogen)
Ovarian Cancer – References:
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).
Compendia-Approved Uses
Code Price**/ Effective Date
managedcareoncology.com 35
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).
HCPCS Code/ generic (Brand) Name
J1440 (300 mcg) filgrastim (Neupogen)
Code Description
Injection, filgrastim (G-CSF), 300 mcg
FDA-Approved Uses
Neutropenia, unspecified (288.00) Congenital neutropenia (288.01) Cyclic neutropenia (288.02) Drug-induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53) Encounter for antineoplastic chemotherapy (V58.11) Convalescence and palliative care- Following chemotherapy (V66.2)
36 managedcareoncology Quarter 4 2008
Compendia-Approved Uses
Myeloid leukemia (205._) Monocytic leukemia (206._) Other specified leukemia (207._) Leukemia of unspecified cell typeAcute (208.0_) Essential thrombocythemia (238.71) 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) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79)
Code Price**/ Effective Date $262.88 9/1/2008
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08 $200.32
CPT Admin Code(s)
90765 90766 90769 90770 90772 90774
HCPCS Code/ generic (Brand) Name
J1441 (480 mcg) filgrastim (Neupogen)
Code Description
Injection, filgrastim (G-CSF), 480 mcg
FDA-Approved Uses
Neutropenia, unspecified (288.00) Congenital neutropenia (288.01) Cyclic neutropenia (288.02) Drug-induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53) Encounter for antineoplastic chemotherapy (V58.11) Convalescence and palliative care- Following chemotherapy (V66.2)
Compendia-Approved Uses
Myeloid leukemia (205._) Monocytic leukemia (206._) Other specified leukemia (207._) Leukemia of unspecified cell typeAcute (208.0_) Essential thrombocythemia (238.71) 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) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79)
Code Price**/ Effective Date $418.69 9/1/2008
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08 $307.23
CPT Admin Code(s)
90765 90766 90769 90770 90772 90774
managedcareoncology.com 37
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).
HCPCS Code/ generic (Brand) Name
J2505 pegfilgrastim (Neulasta)
Code Description
Injection, pegfilgrastim, 6 mg
FDA-Approved Uses
Compendia-Approved Uses
Neutropenia, unspecified (288.00) Congenital neutropenia (288.01) Cyclic neutropenia (288.02) Drug-induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53)
N/A
Code Price**/ Effective Date $3,701.25 9/1/2008
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08
CPT Admin Code(s)
Code Description
Malignant neoplasm of prostate (185)
N/A
$756.25 7/1/2008
$152.48
90772 96402
J3487 zoledronic acid (Zometa)
Injection, zoledronic acid (Zometa), 1 mg
Hypercalcemia (275.42) Multiple myeloma (203.0_) Bone and bone marrow (198.5)
Disorder of bone and cartilage, unspecified (733.90)
$265.36 8/1/2008
$214.06
90765 90774
Compendia-Approved Uses
Myeloid leukemia – Acute (205.0)
Injection, azacitidine, 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)
J9055 cetuximab (Erbitux)
Injection, cetuximab, 10 mg
Malignant neoplasm Malignant neoplasm of colon (153._) of trachea, bronchus, Malignant neoplasm of and lung (162._) rectum, rectosigmoid junction, and anus (154._) 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 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)
90772
Injection, triptorelin pamoate, 3.75 mg
FDA-Approved Uses
J9025 azacitidine (Vidaza)
$2,196.55
J3315 triptorelin pamoate (Trelstar Depot, Trelstar LA)
38 managedcareoncology Quarter 4 2008
HCPCS Code/ generic (Brand) Name
Code Price**/ Effective Date
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08
CPT Admin Code(s)
$5.55 6/1/2008
$4.58
96401 96409 96413
$60.00 1/1/2005
$49.76
96413 96415
managedcareoncology.com 39
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).
HCPCS Code/ generic (Brand) Name
J9150 daunorubicin (Cerubidine)
Code Description
FDA-Approved Uses
Daunorubicin, Lymphoid leukemia – Acute 10mg (204.0_) Myeloid leukemia – Acute (205.0_)
Compendia-Approved Uses
Malignant neoplasm of bone and articular cartilage (170._) Malignant neoplasm of nasal cavities, middle ear, and accessory sinuses (160._) Malignant neoplasm of other endocrine glands and related structures - Adrenal gland (194.0) Lymphosarcoma and reticulosarcoma and other specified malignant tumors of lymphatic tissue (200._ _) Other malignant neoplasms of lymphoid and histiocytic tissue (202._ _) Malignant neoplasm of kidney and other and unspecified urinary organs – Kidney, except pelvis (189.0) Myeloid leukemia – Chronic (205.1_)
Code Price**/ Effective Date $26.25 3/1/2008
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08 $16.90
CPT Admin Code(s)
96409 96413
HCPCS Code/ generic (Brand) Name
Code Description
FDA-Approved Uses
Compendia-Approved Uses
Code Price**/ Effective Date
MedicareAllowable (ASP+6%) –Effective 10/1/0812/31/08
CPT Admin Code(s)
J9202 goserelin acetate (Zoladex)
Goserelin acetate implant, per 3.6 mg
Malignant neoplasm of female breast (174._) Malignant neoplasm of male breast (175._) Malignant neoplasm of prostate (185) Endometriosis (617._) Disorders of menstruation and other abnormal bleeding from female genital tract – Other (626.8)
Precocious sexual development and puberty, not elsewhere classified (259.1)
$469.99 1/27/2000
$189.45
90772 96402
J9211 idarubicin (Idamycin)
Idarubicin HCI, 5mg
Myeloid leukemia – Acute (205.0_)
Lymphoid leukemia – Acute (204.0_)
$442.03 5/1/2008
$234.51
96409 96413
J9218 leuprolide acetate (Lupron)
Leuprolide acetate, per 1mg
Malignant neoplasm of prostate (185)
Malignant neoplasm of female breast (174._) Endometriosis (617._)
$27.45 6/1/2006
$6.68
96402
J9225 histrelin implant (Vantas)
Histrelin implant (Vantas), 50 mg
Malignant neoplasm of prostate (185)
N/A
$6,250.00 1/1/2008
$1,430.40
11981 11982 11983
J9263 oxaliplatin (Eloxatin)
Injection, oxaliplatin, 0.5 mg
Malignant neoplasm of colon (153._) Malignant neoplasm of rectum, rectosigmoid junction, and anus (154._)
Malignant neoplasm of stomach (151._)
$11.87 9/1/2008
$9.56
96413 96415
J9266 pegaspargase (Oncaspar)
Pegaspargase, per single dose vial
Lymphoid leukemia-Acute (204.0_)
N/A
$3,125.00 2/1/2008
$2,618.53
96401 96413 96415
J9355 trastuzumab (Herceptin)
Trastuzumab, 10 mg
Malignant neoplasm of female breast (174._) Malignant neoplasm of male breast (175._)
N/A
$73.85 5/1/2008
$61.49
96413 96415
** The Code Price is based on the HCPCS Code Description. HCPCS (Healthcare Common Procedure Coding System) codes are a component of CMS (Centers for Medicare and Medicaid Services). The Code Price is an AWP-based pricing methodology developed by R_J Health Systems International, LLC., Wethersfield, CT.
Oncology-Related J-Code References • HCPCS Level II Expert 2008 • Current Procedural Terminology (CPT®) 2008 • The Association of Community Cancer Centers’ Compendia-Based Drug Bulletin, May 2008 • DRUGDEX® by Thomson Reuters 2008 • 2008 MMI ICD-9-CM Volumes 1 & 2 Professional for Physicians, . AMA Press, 2008
40 managedcareoncology Quarter 4 2008
• Full prescribing information for each drug listed • The Drug Reimbursement Coding and Pricing Guide by R_J Health Systems International, LLC, Volume 5, Number 4, 4th Quarter 2008 • www.ReimbursementCodes.com powered by R_J Health Systems International, LLC, Wethersfield, CT • CMS (Centers for Medicare and Medicaid Services) – Medicare-Allowable 4th Quarter – Effective Dates 10/1/08–12/31/08
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