Payer Focus:
203.02 Is Required on Kyprolis Claims, Palmetto Says
Published on Thu Nov 15, 2012
Code J9999 is your drug code of choice until a more specific option is available.Attention Palmetto GBA providers: If your physician orders Kyprolis for multiple myeloma patients, be sure your claims match these recently released guidelines.Background: In July 2012, the FDA approved Kyprolis (carfilzomib) for the treatment of multiple myeloma. It's considered a third line treatment because the "patient must first have received two prior therapies including bortezomib and an immunomodulatory agent, and must have shown disease progression within 60 days of completion of the last treatment regimen," Palmetto states.Administration: Typically, physicians order the drug to be administered as a push over two to 10 minutes. A sample schedule could include admin on days 1, 2, 8, 9, 15, and 16, followed by a 12-day rest period from days 17 to 28. One treatment cycle is 28 days. Documentation: Palmetto instructs its providers that the medical record must confirm the [...]