tci Medicare Compliance & Reimbursement - 2004 Issue 40

ONCOLOGY: Get Ready For Increased Chemotherapy Coverage

CMS may expand definition of chemotherapy in 2005.The CPT Editorial Panel made some far-reaching decisions about chemotherapy drug administration codes in its August 2004 meeting, according to a summary shared with the Physician Regulatory Issues Team at the Centers for Medicare & Medicaid Services.The codes discussed in the Panel's meeting don't appear in the preliminary list of 2005 CPT codes obtained by MLR, but CMS may issue them as G-codes.The panel considered four main resolutions suggested by the Drug Administration Workgroup:1) New and revised drug infusion/administration codes. The new codes will set up a hierarchy of...

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