Oncology & Hematology Coding Alert

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Heads up: Your IVIG codes are changing -- again

In July, oncology coders needed to update their charge tickets and software to replace IVIG code J1567 with four new temporary Q codes (see vol. 9 no. 12). You-ll still need those codes for a couple of months -- but starting Jan. 1, 2008, you-ll have to get used to four brand-new J codes.

Why the change? CMS is continuing its plan to ensure accurate payment for single-source drugs (those with no therapeutic equivalent) and biologicals by using unique HCPCS codes. In July, Q4087, Q4088, Q4091 and Q4092 debuted, taking the place of J1567 (Injection, immune globulin, intravenous, non-lyophilized [e.g., liquid], 500 mg). In 2008, new J codes will replace those temporary Q codes.

Medicare also provided two new HCPCS codes, Q4089 and Q4090, for intramuscular injections, payable after July 1, 2007. Those codes are also vanishing in favor of new codes in 2008 (see below).

Don't miss: HPCS 2008 also has new codes for Vectibix, Soliris, Tysabri and Reclast injections, as well as a supply code for an implantable radiation dosimeter.

New and Revised Hematology & Oncology HCPCS Codes

2007

2008

Description

Brand name

N/A

A4650

Implantable radiation dosimeter, each

DVS

C1879

A4648

Tissue marker, implantable, any type, each

 

C9235

J9303

Injection, panitumumab, 10 mg

Vectibix

C9236

J1300

Injection, eculizumab, 10 mg

Soliris

Q4079

J2323

Injection, natalizumab, per 1 mg

Tysabri

Q4087

J1568

Injection, immune globulin (Octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg

Octagam

Q4088

J1569

Injection, immune globulin (Gammagard liquid), intravenous, non-lyophilized (e.g., liquid), 500 mg

Gammagard

Q4089

J2791

Injection, Rho(D) immune globulin (human), (Rhophylac), intramuscular or intravenous, 100 iu

Rhophylac

Q4090

J1571

Injection, hepatitis B immune globulin (HepaGam B), intramuscular, 0.5 ml

HepaGam B

Q4091

J1572

Injection, immune globulin (Flebogamma), intravenous, non-lyophilized (e.g., liquid), 500 mg

Flebogamma

Q4092

J1561

Injection, immune globulin (Gamunex), intravenous, non-lyophilized (e.g., liquid), 500 mg

Gamunex

Q4095

J3488

Injection, zoledronic acid (Reclast), 1 mg

Reclast

Source: The Centers for Medicare & Medicaid Services

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