Article Detail - JE Part B
Billing and Coding: Chemotherapy Administration - R25
This coverage article has been revised and published for notice under contract numbers: 01112 (NCA), 01182 (SCA), 01212 (HI and Territories), and 01312 (NV).
Effective Date of Article: October 19, 2020
Summary of Article Changes: The following updates were made to remove outdated coding information from July and October 2019 in the Group 3 Paragraph table. Added the new and revised HCPCS codes payable in the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) setting to the Group 3 and 4 Paragraph tables effective on 10/01/2020 and are listed below.
- J9305 from Pemetrexed, 10 mg to Pemetrexed, not otherwise classified, 10 mg.
- C9062 for daratumumab and hyaluronidase-fihj (Darzalex FasPro),
- C9064 for Mitomycin pyelocalyceal (Jelmyto™) instillation, 1mg,
- C9065 for romidepsin, non-lypoilized (romidepsin) (e.g. liquid), 1mg,
- C9066 for sacituzumab govitecan-hziy (Trodelvey™), 180 mg all in the OPPS setting, and
- J9227 for isatuximab-irfc (Sarclisa®), 10mg.
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Last Updated Fri, 25 Sep 2020 18:51:40 +0000