tci Part B Insider - 2004 Issue 39

NEW MEDICATIONS: Denied For Unlisted Drugs? List Other Therapies You Tried First

Don't forget crucial information when billing for new MDS drug A new therapy offers hope to many of your patients with myelodysplastic syndromes (MDS) - but only if you can master the intricacies of billing for a drug that lacks its own code. The Food & Drug Administration approved Vidaza on May 19, and providers started billing it over the summer. After a slow start, carriers have started to recognize the drug and pay claims, providers say. One carrier, Cahaba GBA, included a notice in its latest bulletin stating Cahaba would pay for Vidaza as long as providers followed...

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