tci Medicare Compliance & Reimbursement - 2011 Issue 9

Payer Updates: Skip 96402 For GnRH Injections in Noridian Patients

One MAC OKs RNs/LPNs providing annual wellness visits. If your practice sees patients with insurance coverage through Noridian, you'll need to take note of a new chemotherapy drug administration rule from the (MAC). Ensure you're properly reporting injections for these patients before you start seeing denials. As of March 1, you won't be able to use administration code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic) with some drugs as you have in the past. According to information that Noridian first released on May 6, 2010, the preparation and administration of Gonadotropin-releasing hormones (GnRH), also known as luteinizing-hormone-releasing hormones...

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