Oncology & Hematology Coding Alert

Plus: The NPI revolution forces a CMS-1500 update

CMS has a duo of announcements that may change the way you operate every day:

1. Count on CMS to Cover These Off-Label Trial Drugs

Good news if you participate in colorectal cancer trials. CMS announced it will cover the use of oxaliplatin (Eloxatin), irinotecan (Camptosar), cetuximab (Erbitux), or bevacizumab (Avastin) in clinical trials identified by CMS and sponsored by the National Cancer Institute (NCI).

You can find the list of identified trials on the CMS Web site www.cms.hhs.gov/coverage/download/id90b.pdf or on the Web site publishing the decision (www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id=90) under Appendix A.

2. Prepare for New CMS-1500

If you still submit Medicare claims on paper, start using up that stack of forms. To accommodate the switch to the National Provider Identifier (NPI), Medicare is replacing CMS-1500 (12/90) with CMS-1500 (08/05). You can start using the new form as early as Oct. 1, 2006, but you won't be required to use it until Feb. 1, 2007.

Find out more at www.cms.hhs.gov/MLNMattersArticles/downloads/MM4293.pdf.