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Oncology & Hematology Coding Alert

Reader Question:

209.76-209.78 Get Ousted From Palmetto LCD

Published on Fri Aug 05, 2011

Question: We received notice that our local coverage determination (LCD) for Neupogen changed, but it looks the same. What's different?California SubscriberAnswer: The key coding change to the updated Palmetto Part B LCD, effective for services performed on or after June 24, 2011, is a revision of the ICD-9 codes supporting medical necessity. The previous version included 209.70- 209.79 (Secondary neuroendocrine tumors). The updated version lists 209.70-209.75 and 209.79.Reality: The change does not affect current coverage. The change may seem to suggest that codes 209.76- 209.78 no longer support medical necessity for treatment to reduce the incidence of febrile neutropenia following chemotherapy (the topic of the LCD), but 209.76-209.78 do not exist under ICD-9 2011. Therefore the change simply clarifies which valid codes support coverage.Helpful: Revisions can be hard to spot, but you should see a list of revisions at the end of the LCD. The list shows a history of [...]
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