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August 6, 2007 Part B Medicare Bulletin

Posted August 6, 2007

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Alefacept – Retired LCD

The Local Coverage Determination for alefacept has been retired for all three CIGNA Government Services states, effective July 15, 2007. The coverage will continue to be based on the FDA-approved indications and information in the package insert, and on the general principles expressed in the retired LCD. This drug should only be prescribed for appropriate patients with moderate to severe chronic plaque psoriasis, by clinicians experienced in its use.

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Appeals Transition - BIPA Section 521 Appeals

An Overview of Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals educational video program, provides information on Medicare-covered preventive services, risk factors associated with various preventable diseases, and highlights the importance of prevention, detection, and early treatment of disease. The program is an excellent resource to help physicians, providers, suppliers, and other health care professionals learn more about preventive benefits covered by Medicare. Running approximately 75 minutes in length, the program is suitable for individual viewing or for use in conjunction with a conference or training session. To order your copy today, go to the Medicare Learning Network Product Ordering page at
http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident=kc0001&loc=5 on the CMS Web site. Available in DVD or VHS format.

Provider Types Affected
Physicians, providers, and suppliers submitting claims to Medicare contractors (carriers, DME Medicare Administrative Contractors (DME MACs), Fiscal Intermediaries (FIs), Part A/B Medicare Administrative Contractors (A/B MACs), and/or Regional Home Health Intermediaries (RHHIs)) for services provided to Medicare beneficiaries.

Provider Action Needed
This article is based on Change Request (CR) 5460, which notifies Medicare contractors about their need to comply with changes to provisions in Chapter 29 of the Medicare Claims Processing Manual (Publication 100-04) that address the appointment of representatives, fraud and abuse, guidelines for writing appeals correspondence, and the disclosure of information.

Background
The Medicare claims appeals process was amended by the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA) and the Medicare Prescription Drug Improvement and Modernization Act (MMA). The Social Security Act (Section 1869(c)), as amended by BIPA and MMA, requires changes to the Code of Federal Regulations (CFR; Title 42) regarding:

  • Appointment of representatives,
  • Fraud and abuse,
  • Guidelines for writing appeals correspondence, and • The disclosure of information.

Therefore, the Centers for Medicare & Medicaid Services (CMS) is revising provisions in Chapter 29 of the Medicare Claims Processing Manual that address these changes.

The purpose of CR5460 is to notify Medicare contractors about their need to comply with these revised Medicare Claims Processing Manual provisions, which are included as an attachment to CR5460.

Some of the key changes to the manual direct Medicare contractors to:

  • Follow the procedures that define who may be a representative and how a representative is
    appointed (via the CMS-1696 Appointment of Representative (AOR) form);
    • Do not accept an appointment if the contractor has evidence that the appointment should not be honored;
    • Send notice only to the representative when the contractor takes action or issues a redetermination [if there is an appointed representative];
    • Provide assistance in completing the CMS- 1696 form, as needed; and
    • Do not release beneficiary-specific information to a representative before the beneficiary or appellant and the prospective representative have completed and signed the CMS-1696 or other conforming written instrument.

Please note that the AOR applies to all services, claims and appeals submitted on behalf of the beneficiary for the duration of the AOR.

  • Follow the procedures that describe the process a beneficiary must use to assign their appeal rights to a provider (via the CMS-20031) Transfer of Appeal Rights form):
    • For each new appeal request, a form needs to be submitted, this form is valid for all levels of the appeal process including judicial review, even in the event of the death of the beneficiary;
    • If a provider furnishes the service, he/she would be a party to the initial determinations, only pro viders or suppliers who are not a party may accept assignment of appeal rights
      from a beneficiary. That is assignment of appeal rights applies only to providers and
      suppliers who are never a party to an appeal because they do not participate in Medicare and have not taken the claim on assignment; and
    • The provider or supplier who accepts the appeal rights to collect payment from the
      beneficiary for the item or service that is the subject of the appeal. The provider or supplier may collect any applicable deductible or coinsurance. The provider or supplier agrees to this waiver by completing and signing Section II of the Transfer of Appeal Rights form.
    • Provide redetermination letters that are understandable to beneficiaries.

Please note that an Assignment of Appeal Rights is valid for the duration of an appeal unless it is revoked by the beneficiary.

Additional Information
The official instruction, CR5460, issued to your Medicare contractor regarding this change may be viewed at http://www.cms.hhs.gov/Transmittals/downloads/R1274CP.pdf on the CMS Web site. The revised portions of the Medicare Claims Processing Manual are attached to that CR.

If you have any questions, please contact your Medicare contractor at their toll-free number, which may be found on the CMS Web site at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip

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Azacitidine (Vidaza) – Retired LCD

CIGNA Government Services has retired the LCD for azacitidine (Vidaza) for all three CIGNA Government Services state jurisdictions, effective August 1, 2007. Thereafter, drug will be covered for its FDA-approved, Compendia-listed indications only. CIGNA Government Services expects the general instructions in the retired LCD for use will be followed in the future, and that the drug will continue to be primarily used by physicians well experienced in its use. This will be followed on a post-pay basis.

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Bone Mass Measurements (BMMs)

Note: This article was revised June 4, 2007 to clarify the Medicare Summary Notices on page 3. Essentially, MSN 16.10 will be issued with a denied claim as well as either MSN 36.1 or MSN 36.2, depending on if an ABN was issued. All other information remains the same.

Provider Types Affected
Physicians, practitioners and hospitals that bill Medicare contractors (carriers, fiscal intermediaries (FIs), or Part A/B Medicare administrative contractors (A/B MACs) for BMM services

Provider Action Needed

STOP – Impact to You
Effective for dates of service on or after January 1, 2007, Medicare will pay for BMM services for dual-energy x-ray absorptiometry (CPT code 77080) when this procedure is used to monitor osteoporosis drug therapy. In addition, new CPT were assigned to BMMs.

CAUTION – What You Need to Know
Medicare edits will deny claims that are not consistent with revised BMM policy and providers may be liable for noncovered BMMs unless they have issued an advanced beneficiary notice (ABN) as required. This article explains the changes as a result of the CY2007 Physician Fee Schedule Final Rule.

GO – What You Need to Do
See the remainder of this article for important information regarding billing Medicare for BMMs.

Background
This article and related Change Request (CR) 5521 wants providers to know that on June 24, 1998, the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule with Comment Period (IFC) in the Federal Register entitled “Medicare Coverage of and Payment for Bone Mass Measurements.” This IFC implemented section 4106 of the BBA by establishing 42 CFR 410.31, Bone Mass Measurement: Conditions for Coverage and Frequency Standards. This new regulation defined BMM and individuals qualified to receive a BMM, established conditions for coverage under the “reasonable and necessary” provisions of 1862(a)(1)(A) of the Act, and established frequency standards governing when qualified individuals would be eligible for a BMM.

On December 1, 2006, CMS published the CY 2007 Physician Fee Schedule final rule, which included changes to 42 CFR 410.31. These changes can be found in Chapter 15, Section 80.5 of the Medicare Benefit Policy Manual. and in Chapter 13, Section 140 of the Medicare Claims Processing Manual. The revised manual sections are attached to CR5221. The Web address for viewing CR5221 is available in the “Additional Information” section at the end of this article.

Key Points
Listed is a summary of the revisions and additions to Chapter 13 of the Medicare Claims Processing Manual and Chapter 15 of the Medicare Benefit Policy Manual.

CHAPTER 13

Effective for dates of service on and after January 1, 2007, the CY 2007 Physician Fee Schedule final rule expanded the number of beneficiaries qualifying for BMM by reducing the dosage
requirement for glucocorticoid (steroid) therapy from 7.5 mg of prednisone per day to 5.0 mg.
It also changed the definition of BMM by removing coverage for a single-photon absorptiometry (SPA) as it is not considered reasonable and necessary under section 1862 (a)(1)(A) of the Act.

Note: Medicare will not cover single photon absorptiometry and procedure code 78350 will be denied (using MSN# 16.10) for services on or after January 1, 2007.

CHAPTER 15

NOTE: Since not every woman who has been prescribed estrogen replacement therapy (ERT) may be receiving an “adequate” dose of the therapy, the fact that a woman is receiving ERT should not preclude her treating physician or other qualified treating nonphysician practitioner from ordering a bone mass measurement for her. If a BMM is ordered for a woman following a careful evaluation of her medical need, however, it is expected that the ordering treating physician (or other qualified treating nonphysician practitioner) will document in her medical record why he or she believes that the woman is estrogen-deficient and at clinical risk for osteoporosis.

Additional Information
For complete details regarding this Change Request (CR) please see the official instruction (CR5521) issued to your Medicare carrier, FI or A/B MAC. That instruction consists of 3 transmittals, i.e.:

If you have questions, please contact your Medicare carrier, FI or A/B MAC, at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

A brochure outlining ‘Bone Mass Measurements’ is available at http://www.cms.hhs.gov/MLNProducts/downloads/bone_mass_06-08-05.pdf .

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Charges for Missed Appointments

National Provider Identifier (NPI) News – Medicare is now asking that submitters send a small number of claims using only the NPI. If no claims are rejected, the submitter can gradually increase the volume. Additional information can be found at the CMS NPI Web site at http://www.cms.hhs.gov/NationalProvIdentStand/.

Provider Types Affected
Physicians, providers, and suppliers who submit claims to Medicare contractors (carriers, fiscal intermediaries (FIs), or Part A/B Medicare administrative contractors (A/B MACs)).

Provider Action Needed

STOP – Impact to You
The Centers for Medicaid & Medicare Services (CMS) policy is to allow physicians and suppliers to charge Medicare beneficiaries for missed appointments. However, Medicare itself does not pay for missed appointments, so such charges should not be billed to Medicare.

CAUTION – What You Need to Know
Providers may not charge ONLY Medicare beneficiaries for missed appointments; they must also charge non-Medicare patients. The amount the physician/supplier charges Medicare beneficiaries for missed appointments must be the same as the amount that they charge non-Medicare patients.

GO – What You Need to Do
Make certain that your billing staff is aware that you may bill the beneficiary directly, that Medicare itself does not make any payments for missed appointments, and that Medicare should not be billed for these charges.

Background
According to Chapter 12, section 30.3.13 of the Medicare Claims Processing Manual, which is attached to CR5613, CMS policy allows physicians, providers, and suppliers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge non-Medicare patients for missed appointments and the charges for Medicare and non-Medicare patient are the same. The charge for a missed appointment is not a charge for a service itself (to which the assignment and limiting charge provisions apply), but rather is a charge for a missed business opportunity. Therefore, if a physician’s or supplier’s missed appointment policy applies equally to all patients (Medicare and non-Medicare), then the Medicare law and regulations do not preclude the physician or supplier from charging the Medicare patient directly.

The other key points of CR5613 are:

Additional Information
For complete details regarding this Change Request (CR) please see the official instruction (CR5613) issued to your Medicare carrier, FI or A/B MAC. That instruction may be viewed by going to http://www.cms.hhs.gov/Transmittals/downloads/R1279CP.pdf on the CMS Web site.

If you have questions, please contact your Medicare carrier, FI or A/B MAC, at their toll-free number which may be found at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

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Claims Processing Change for Services Submitted with Health Professional Shortage Area (HPSA) Modifiers QB or QU for Claims with Dates of Service On or After January 1, 2006

Provider Types Affected
Physicians submitting claims to Medicare Part A/B Medicare Administrative Contractors (A/B MACs), or carriers for services rendered to Medicare beneficiaries in health professional shortage areas.

Provider Action Needed

STOP – Impact to You
For dates of service on or after January 1, 2006, when a modifier is required to bill for the HPSA bonus, use the AQ modifier for physician services provided in HPSAs. Claims will be returned as unprocessable if submitted with the QB or QU modifiers, when submitted for dates of service on or after January 1, 2006.

CAUTION – What You Need to Know
Make certain that services eligible to receive a HPSA bonus for dates of service on or after January 1, 2006, are billed with the AQ modifier, when a modifier is required.

GO – What You Need to Do
Make certain that your billing staffs are aware of these changes.

Background
Under certain circumstances, it is necessary to include a modifier on a claim in order to receive a HPSA bonus payment. The QB and QU modifiers are the appropriate modifiers to be submitted for claims with dates of service prior to January 1, 2006. The AQ modifier is the appropriate modifier to be used for dates of service on or after January 1, 2006. Per direction from the Centers for Medicare & Medicaid Services (CMS), some Medicare contractors allow claims submitted with the QB and QU modifiers with dates of service on or after January 1, 2006 to be submitted and processed, though no bonus payment is made as the correct modifier has not been submitted. According to Health Insurance Portability and Accountability Act (HIPAA) regulations for transactions and code sets, as found in 45 Code of Federal Regulations (CFR) 160, providers must include valid codes and modifiers, as derived from the standard transaction code sets, on their incoming claims submitted to Medicare. Therefore, allowing claims with inappropriate modifiers to be accepted into the Medicare claims processing system constitutes a violation of the HIPAA standard transaction code sets.

In order to comply with HIPPA regulations and allow claims to be forwarded successfully to supplemental payers, as of October 1, 2007, Medicare will no longer accept claims submitted with the QB or QU modifiers for invalid dates of service. Claims must be submitted with the correct modifiers for the correct dates of service in order to be processed.

Additional Information
For complete details regarding this Change Request (CR) please see the official instruction (CR5629) issued to your Medicare carrier, or A/B MAC. That instruction may be viewed by going to http://www.cms.hhs.gov/Transmittals/downloads/R1275CP.pdf on the CMS Web site.

If you have questions, please contact your Medicare carrier, or A/B MAC, at their toll-free number which may be found at: http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

Additional information on the HPSA bonus and the physician scarcity area bonus can be found at
http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/01_overview.asp on the CMS Web site.

The Guide for Using the HPSA/PSA Web Page can be viewed by going to http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/Downloads/instructions.pdf on the CMS Web site.

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Clarification of Manual Instruction Regarding Scope of Portable X-Ray Benefit

Provider Types Affected
Medicare providers who submit claims to Medicare contractors (Fiscal intermediaries (FIs), Part A/B Medicare Administrative Contractors (A/B MACs), carriers) for services rendered to Medicare beneficiaries for portable x-rays.

Provider Action Needed

STOP – Impact to You
Currently, the Medicare Benefit Policy Manual, Publication 100-02, chapter 15, section 80.4.3, relating to the scope of portable x-ray benefit is not completely consistent with regulations at 42 CFR 410.32(c)(3)(i). The manual section states that “skeletal films involving arms and legs” are covered services under the portable x-ray benefit.

CAUTION – What You Need to Know
In order to make certain the manual conforms to the regulations, the Centers for Medicare & Medicaid Services (CMS) is revising the manual to state that the benefit includes “skeletal films involving extremities”. Although, the language differences are slight, the use of “extremities” in the regulation instead of “arms and legs” delineates coverage beyond ‘arms and legs’ to the hands, feet, toes, fingers, wrist and ankle. Language is also being added to include the coverage of diagnostic mammograms, when certain requirements are met.

GO – What You Need to Do
Make certain that your billing staffs are aware of these changes. Also, be aware that Medicare contractors will adjust claims previously processed incorrectly, if you bring those claims to their attention.

Background
CR5536 is the official document that announces these changes in Medicare processes. Attached to this document is the revised section of the Medicare Benefit Policy Manual section 80.4.3 - Scope of Portable X-Ray Benefit (Rev.71, Issued: 05-25-07, Effective: N/A; Implementation: July 2, 2007) the manual revision reads as follows and the bolded sections are new :

In order to avoid payment for services, which are inadequate or hazardous to the patient, the scope of the covered portable x-ray benefit is defined as:

Additional Information
For complete details regarding this Change Request (CR) please see the official instruction (CR5536) issued to your Medicare carrier, FI, or A/B MAC. That instruction may be viewed by going to http://www.cms.hhs.gov/Transmittals/downloads/R71BP.pdf on the CMS website.
If you have questions, please contact your Medicare carrier, FI or A/B MAC, at their toll-free number which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

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Clarification of the National Provider Identifier (NPI) Reporting Requirements for Ambulance Service Claims

National Provider Identifier (NPI) News – Medicare is now asking that submitters send a small number of claims using only the NPI. If no claims are rejected, the submitter can gradually increase the volume. Additional information can be found at the CMS NPI Web site at http://www.cms.hhs.gov/NationalProvIdentStand/.

Provider Types Affected
Providers and suppliers who bill Medicare carriers and Medicare Administrative Contractors (MACs) for ambulance services.

What You Need to Know
CR 5564, from which this article is taken, notifies carriers and Medicare Administrative Contractors (MACs) to not require you to include the ordering/referring physician’s National Provider Identifier (NPI) on your claims for ambulance services.

You should make sure that your billing staffs are aware of this exception.

Background
Section 1833(q) of the Social Security Act (the Act), requires that the ordering/referring physician’s name be provided on all claims for Medicare covered services and items resulting from a physician’s order or referral. In addition, when the NPI reporting requirements go into effect according to the Medicare fee-for-service NPI contingency plan, the ordering/referring physician’s NPI will also be required on these claims; except, however, on claims for ambulance services (as explained in the paragraphs below). (See MLN Matters article, MM5595, available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5595.pdf on the CMS Web site for details about the NPI contingency plan.)

The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandate the adoption of a standard unique health identifier for each health care provider. In response to this mandate, the Centers for Medicare and Medicaid Services (CMS) in the National Provider Identifier (NPI) final rule (published on January 23, 2004) established the NPI as this standard.
Although providers/suppliers may begin reporting the NPI as early as January 1, 2007, all health care providers covered under HIPAA must comply with the requirements of the NPI final rule in accordance with Medicare’s NPI contingency plan. At the appropriate date, Medicare will reject claims in which the appropriate name and NPI are not entered in the required fields of the Form CMS-1500 paper claim format, version 08-05 (fields 17 and 17B, respectively), and the ANSI X12 837-P electronic claim format, version 4010A (NM1 segment of the 2310A and/or 2420E loop, respectively).

However, ambulance services (particularly transports provided in response to a 911 or 911-equivalent emergency call) are often ordered by someone other than a physician. In these situations, the name and the NPI of the ordering/referring physician are not available. Thus, CMS does not feel that it is appropriate to require that this information be submitted on the claim form. Therefore, CR 5564, from which this article is taken, instructs carriers and the Medicare Administrative Contractors (MACs) that the ordering/referring physician’s NPI is not required on claims for ambulance services.

Additional Information
You can find the official instruction, CR 5564, issued to your carrier or MAC by visiting http://www.cms.hhs.gov/Transmittals/downloads/R1251CP.pdf on the CMS Web site.

If you have any questions, please contact your carrier or MAC at their toll-free number, which may be found at http://www.cms.hhs.gov/MLNProducts/downloads/CallCenterTollNumDirectory.zip on the CMS Web site.

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Comprehensive Error Rate Testing (CERT) Report

The May 2007 Comprehensive Error Rate Testing (CERT) Report was published on May 15, 2007, on the CERT Web site, www.cms.hhs.gov/cert/ indicating that the national paid claims error rate for this reporting period is 4.2%, which equates to $10.4B.

Services incorrectly coded stood out as one of the top reasons for CERT errors. Specifically, the majority of these incorrectly coded claims relate to incorrectly coded Evaluation and Management (E&M) services in which the level of E&M service billed is not supported by the documentation submitted pertaining to the patient’s condition and the key components of the E&M service.

This high rate of incorrectly coded Evaluation and Management (E&M) services generally implies that providers may be in need of education or review on how to properly code an Evaluation and Management (E&M) visit. Selecting the appropriate Evaluation and Management (E&M) code should be based upon medical necessity and the content of the service provided to the patient which needs to be supported by documentation in the patient’s medical record.

It is important to remember:

  1. Documentation of the key components – the History, Physical Exam, and Medical Decision
    Making – should support the level of the E&M service billed.
  2. Per the Medicare Claims Processing Manual, Chapter 12, the selection of the level of Evaluation and Management service may be based on the duration of Coordination of Care and/or
    Counseling. When counseling and/or coordination of care dominates (more than 50 percent) the face- to-face physician/patient encounter or the floor time (in the case of inpatient services), time is the key or controlling factor in selecting the level of service. The physician must document time
    spent with the patient in conjunction with the medical decision-making involved and a
    description of the coordination of care or counseling provided. Documentation must be in
    sufficient detail to support the claim.
  3. All billed E&M services must be based only on activities that are reasonable and necessary for the
    diagnosis or treatment of illness or injury (SSA 1862(a) (1) (A). “. . . Documentation of History, Physical Examinations, and Medical Decision Making should not be performed or billed at levels greater than needed for the patient’s condition.”
  4. As documented in the Medicare Claims Processing Manual, Chapter 12, Section 30.6.1, “Medical
    necessity of a service is the overarching criterion for payment in addition to the individual
    requirements of a CPT code. It would not be medically necessary or appropriate to bill a higher level of Evaluation and Management service when a lower level of service is warranted. The volume of documentation should not be the primary influence upon which a specific level of service is billed. Documentation should support the level of service reported. The service should be documented during, or as soon as practicable after it is provided in order to maintain an accurate medical record.”

It Is Important To Note:

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Covered Indications for Chemotherapy Drugs and their Adjuncts

Spring 2007 Update
(Updates to ICD-9 Covered Indications are in Bold Numbers)

Labeled and Off-labeled Indications were based on the FDA Labeled Indications, the Spring 2007 Update of the Association of Community Cancer Centers Compendia Based Drug Bulletin and approved indications per the Carrier Medical Directors. Diagnoses other than those listed below may be covered, if the carrier receives information that would support the medical efficacy of the drug for that condition.

Abarelix J0128
185
See NCD – 100-19
Aldesluekin J9015
 172.0-172.9, 189.0, 189.1, 200.00 to 200.88, 202.00 to 202.98, 205.00 to 205.11
Alemtuzumab J9010
 204.10, 204.11
Arsenic Trioxide J9017
 205.00, 205.20, and 238.71 to 238.79
Asparaginase J9020
 172.0–172.9, 200.00 to 202.98, 204.00-204.11, 205.00 to 208.01
Bacillus Calmette-Guerin J9031
 188.0-188.9, 233.7, 233.9
Bevacizumab J9035
 153.0-154.8, 162.0-162.9, 174.0-175.9, 362.52
Bleomycin J9040
 140.0 to 150.9, 157.0-157.9, 160.0–161.9, 170.0 to
173.9, 176.0–176.9, 180.0–180.9, 182.0, 183.0, 183.9, 184.4, 186.0 to 187.4, 188.0 to 189.1, 189.3, 193, 195.0, 197.2, 197.6, 198.5, 200.00 to 202.98, 236.1.
Bortezomib (Velcade) J9041
202.80 to 202.88, 203.00 to 203.01
Carboplatin J9045
140.0 to 151.9, 153.9, 154.2, 154.3, 155.0-155.2, 156.0 to 158.9, 160.0 to 165.9, 170.0 to 199.1, 200.00 to 204.91, 236.1
Carmustine J9050
 151.0–151.9, 153.0 to 155.2, 162.2-162.9, 170.0- 170.9, 172.0 to 175.9, 191.0-191.9, 200.00 to 203.81, 273.3
Cetuximab J9055
 140.0 to 149.9, 153.0 to 154.8, 160.0 to 161.9, 195.0
Cisplatin J9060 & J9062
 140.0 to 151.9, 153.9, 154.2-154.3,155.0- 155.2, 156.0 to 158.9, 160.0 to 165.9, 170.0 to 199.1, 200.00 to 204.91, 236.1
Cladribine J9065
 200.00 to 202.98, 204.10, 204.11, 273.3
Cyclophosphamide J9070, J9080, J9090, J9091, J9092 Cyclophosphamide, Lyophilized J9093 to J9097
 140.0 to 149.9, 153.0 to 154.8, 157.0-157.9, 160.0 to 165.9, 170.0 to 175.9, 180.0 to 195.0, 198.5, 200.00 to 204.11, 205.00 to 208.01, 236.1, 273.2, 273.3, 273.9, 282.9, 283.0, 287.30 to 287.5, 340, 446.0, 446.20, 446.4, 446.5, 447.6, 515, 517.2, 583.81, 695.4, 710.0 to 710.4, 710.9, 714.0 to 714.9 Cytarabine J9100 & J9110
 198.4, 200.00 to 202.98, 204.00, 204.01, 204.11, 205.00 to 207.01, 238.71 to 238.79
Cytarabine Liposome Injection J9098
 198.4
Dacarbazine J9130 & J9140
 157.0 – 157.9, 160.0 to 194.9, 201.00-201.98
Dactinomycin J9120
 170.0 to 172.9, 174.0 to 176.9, 181, 182.0, 183.0- 183.9, 186.0-186.9, 189.0, 198.5, 204.00, 204.01, 204.11, 236.1
Daunorubicin J9150
 160.0-160.9, 170.0-170.9, 189.0, 194.0, 200.00- 200.88, 202.00-202.98, 204.00-204.91, 205.00 -205.11
Daunorubicin Citrate, Liposomal J9151
 176.0-176.9
Decitabine J0894
 238.71-238.79
Denileukin Difitox J9160
 173.0-173.9, 200.00-200.88, 202.00-202.98
Dexrazoxane Hydrochloride J1190
 174.0 to 175.9, 995.20, 995.27, 995.29, Diethylstillbestrol J9165
174.0 to 175.9, 185
Docetaxel (Taxotere) J9170
 140.0 to 151.9, 157.0-157.9, 160.0 to 162.9, 171.0- 171.9, 174.0 to 175.9, 179, 183.0-183.9, 185, 188.0-188.9, 195.0
Doxorubicin J9000
 140.0 to 157.9, 160.0-162.9, 164.0, 164.8, 170.0- 171.9, 174.0-176.9, 180.0-180.9, 181, 182.0, 183.0, 183.9, 185, 186.0, 186.9, 188.0-188.9, 189.0, 190.5, 193, 194.0, 195.0, 198.5, 200.00 to 204.11, 205.00-20501, 236.1, 259.2
Epirubicin Hydrochloride J9178
 150.0 to 151.9, 162.2-162.9, 171.0-171.9, 174.0 to 175.9, 183.0-183.9, 200.00 to 202.98
Etoposide J9181, J9182
 151.0-151.9, 155.0, 155.2, 160.0-160.9, 162.0- 162.9, 164.0-164.9, 170.0 to 171.9, 173.0 to 176.9, 181, 182.0 to -183.9, 184.0, 186.0-186.9, 188.0 to 189.9, 190.5, 191.0-191.9, 194.0 to 195.8, 198.5, 199.0-199.1, 200.00 to 207.01, 236.1
Floxuridine J9200
 140.0 to 149.9, 151.0-151.9, 153.0 to 154.8, 155.0, 155.2, 156.0-156.9, 161.0-161.9, 174.0 to 175.9, 180.0-180.9, 183.0-183.9, 185, 188.0 to 189.1, 189.3, 191.0-191.9, 195.0, 204.00-204.11, 205.00 to 208.01
Fludarabine Phosphate J9185
 173.0-173.9, 200.00 to 202.98, 204.10, 204.11, 204.90-204.91, 205.00 to 208.01, 273.0-273.3
Fluorouracil J9190
 140.0 to 199.1, 259.2
Fulvestrant J9395
 174.0 to 175.9
Gallium Nitrate J1457
 Primary ICD-9 for the malignancy plus 275.42 as Secondary DX
Gemcitabine J9201
 156.0-156.9, 157.0 to 158.9, 162.2-162.9, 164.2, 164.3, 164.8, 164.9, 174.0 to 175.9, 179, 181, 183.0-183.9, 186.0-186.9, 188.0-188.9, 194.4, 200.00 to 202.98
Gemtuzumab Ozogamicin J9300
 205.00 to 207.11
Granisetron Hcl. J1626
 787.01, 787.03, 995.20, 995.29 Anti-emetic (chemotherapy-induced)
Idarubicin J9211
 204.00-204.11, 205.00-208.01, 238.71-238.79
Ifosfamide J9208
 140.0 to 149.9, 157.0-157.9, 160.0-161.9, 162.2- 162.9, 164.0, 164.2 – 164.3, 164.8 -164.9, 170.0 to 171.9, 174.0 to 175.9, 180.0 to 183.9, 186.0- 186.9, 188.0 to 189.0, 194.0-194.9, 195.0, 198.5, 200.00 to 202.98, 204.00 to 207.81
Interferon Alpha-1 J9212, Interferon Alpha-2A J9213, Interferon Alpha-2B J9214, Interferon Alpha-N3 J9215, Interferon Gamma 1-B J9216