tci Medicare Compliance & Reimbursement - 2006 Issue 26

Industry Notes: You Could Have An Easier Time Billing For Off-Label Cancer Drug Uses Soon

Beware denials that result in LUPAs Congress should expand national coverage for off-label uses of cancer drugs, the American Society of Clinical Oncology argues in the July 1 Journal of Clinical Oncology.  Congress should require Medicare contractors to consider peer-reviewed literature as they make coverage decisions about off-label cancer drugs, ASCO says. Non-Medicare insurers should follow Medicare rules on off-label cancer drug use, ASCO adds. RHHI Denies 75 Percent Of Claims With 1 Nursing, 4 Therapy Visits When you submit a claim with one nursing and four therapy visits, you'd better be ready to defend it. Regional...

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