tci Part B Insider - 2003 Issue 26

Coverage: Learn the New LMRPs Before They Apply to You

The Part B carriers are constantly hard at work defining what Medicare will cover in their states. Even though policies may differ from state to state, it's still worth seeing what rules are coming into place elsewhere, because you could be next. Carrier Cahaba GBA introduced a draft LMRP in Georgia for the cancer drug Bexxar, for which the carrier now accepts unlisted-drug code J9999. Cahaba will cover Bexxar for ICD-9 Codes 200.00-200.88 (Lymphosarcoma and reticulosarcoma) and 202.00-202.98 (Other malignant neoplasms of lymphoid and histiocytic tissue). Patients must have non-Hodgkins lymphoma that is "refractory...

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