AHA Coding Clinic® for HCPCS - 2001 Issue 3; FOR your INFORMATION

“Lomustine (C9017)” no longer eligible for pass-through status

Effective April 1, 2001, Lomustine, previously approved for transitional pass-through status, is no longer considered by Medicare to be a drug qualifying, for coverage as an oral chemotherapeutic agent under 1861(s)(2)(Q). As a result: HCPCS code C9017 and APC 9017 will be deleted from the October 1, 2001, release of the Outpatient Code Edits (OCEs).  The July 1, 2001, release of PRICER has been updated to reflect these determinations. Instructions for claims processing: Do not search for previously adjudicated claims with regards to Lomustine. However, only re-open and reprocess claims brought to your attention. ♦ ...

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