Practice Management Alert

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If your practice sees patients with insurance coverage through Noridian, you'll need to take note of a new chemotherapy drug administration rule from the (MAC). Ensure you're properly reporting injections for these patients before you start seeing denials.

As of March 1, you won't be able to use administration code 96402 (Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic) with some drugs as you have in the past. According to information that Noridian first released on May 6, 2010, the preparation and administration of Gonadotropin-releasing hormones (GnRH), also known as luteinizing-hormone-releasing hormones (LHRH) does not meet the CPT manual requirements of the use of the chemotherapy administration codes.

Noridian issued a notice that stated: "Medicare considers the use of the chemotherapy administration codes to appropriately describe the parenteral administration of the following drugs ONLY:

• J1745 Injection Infliximab
• Any non-GnRH drug/compound listed in the current HCPCS section 'CHEMOTHERAPY DRUGS J9000-J9999.' Examples of GnRH and analogs include but are not limited to J9217 and J9218."

Turn To 96372: You'll no longer be able to report 96402 for the administration. Instead of chemotherapy drug administration codes 96401-96549, you should choose a code from the 96360-96379 code series, according to Noridian.