New Code Description
199.20 Malignant neoplasm associated with transplanted organ
203.02 Multiple Myeloma in relapse
203.12 Plasma cell Leukemia in relapse
203.82 Other immunoproliferative neoplasms in relapse
204.02 Lymphoid leukemia acute in relapse
204.12 Lymphoid leukemia chronic in relapse
204.22 Lymphoid leukemia subacute in relapse
204.82 Other lymphoid leukemia in relapse
204.92 Unspecified lymphoid leukemia in relapse
205.02 Myeloid leukemia acute in relapse
205.12 Myeloid leukemia chronic in relapse
205.22 Myeloid leukemia subacute in relapse
205.32 Myeloid sarcoma in relapse
205.82 Other myeloid leukemia in relapse
205.92 Unspecified myeloid leukemia in relapse
206.02 Monocytic leukemia acute in relapse
207.02 Acute erythremia and erythroleukemia in relapse
207.12 Chronic erythremia in relapse
208.82 Other leukemia of unspecified cell type in relapse
209 Neuroendocrine Tumors  (*New Category*)
209.0 Malignant carcinoid tumors of the small intestine
209.00 Malignant carcinoid tumors of the small intestine, unspecified portion
209.01 Malignant carcinoid tumor of the duodenum
209.02 Malignant carcinoid tumor of the jejunum
209.03 Malignant carcinoid tumor of the ileum
209.1 Malignant carcinoid tumors of the appendix large intestine and rectum
209.10 Malignant cardinoid tumor of the large intestine, unspecified portion
209.11 Malignant carcinoid tumor of the appendix
209.12 Malignant cardinoid tumor of the cecum
209.13 Malignant carcinoid tumor of the ascending colon                          209.14 Malignant carcinoid tumor of the tranverse colon
209.15 Malignant carcinoid tumor of the descending colon
209.16 Malignant carcinoid tumor of the sigmoid colon
209.17 Malignant carcinoid tumor of the rectum
209.2 Malignant carcinoid tumor of other and unspecified sites
209.20 Malignant carcinoid tumor of unknown primary site
209.21 Malignant carcinoid tumor of the bronchus and lung
209.22 Malignant carcinoid tumor of the thymus
209.23 Malignant carcinoid tumor of the stomach
209.24 Malignant carcinoid tumor of the kidney
209.25 Malignant carcinoid tumor of the foregut not otherwise specified
209.26 Malignant carcinoid tumor of the midgut not otherwise specified
209.27 Malignant carcinoid tumor of the hindgut not otherwise specified
209.29 Malignant carcinoid tomor of other sites
209.3 Malignant poorly differentiated neuroendocrine tumors
209.30 Malignant poorly differentiated neoroendocrine carcinoma any site
209.4 Benign carcinoid tumors of the small intestine
209.40 Benign carcinoid tumor of the small intestine unspecified portion
209.41 Benign carcinoid tumor of the duodenum
209.42 Benign carcinoid tumor of the jejunum
209.43 Benign carcinoid tumor of the ileum
209.5 Benign carcinoid tumors of the appendix large intestine and rectum
209.50 Benign carcinoid tumor of the large intestine unspecified portion
209.51 Benign carcinoid tumor of the appendix
209.52 Benign carcinoid tumor of the cecum
209.53 Benign carcinoid tumor of the ascending colon
209.54 Benign carcinoid tumor of the transverse colon
209.55 Benign carcinoid tumor of the descending colon
209.56 Benign carcinoid tumor of the sigmoid colon
509.57 Benign carcinoid tumor of the rectum
209.6 Benign carcinoid tumor of other and unspecified sites
209.60 Benign carcinoid tumor of unknown primary site
209.61 Benign carcinoid tumor of the bronchus and lung
209.62 Benign carcinoid tumor of the thymus                                          209.63 Benign carcinoid tumor of the stomach
209.64 Benign carcinoid tumor of the kidney
209.65 Benign carcinoid tumor of the foregut not otherwise specified
209.66 Benign carcinoid tumor of the midgut not otherwise specified
209.67 Benign carcinoid tumor of the hindgut not otherwise specified
209.69 Benign carcinoid tumor of other sites
233.1 Carcinoma in situ, cervix uteri
238.77 Post-Transplant lymphoproliferative disorder
289.84 Heparine-induced thrombocytopenia, HIT
339.3 Drug-induced headache, NEC
511.81 Malignant pleural effusion
999.81 Extravasation of vesicant chemotherapy
999.82 Extravasation of other vesicant chemotherapy
999.88 Other infusion reaction
999.89 Other transfusion reaction
V87.41 Personal history of antineoplastic chemotherapy
V87.42 Personal history of monoclonal drug therapy
V87.49 Personal history of other drug therapy
NOTE:  The new diagnosis code category and sub-categories under 209 have been highlighted in RED.

Revised Code Description
203.00 Multiple Myeloma without mention of having achieved remission
203.10 Plasma Cell Leukemia without mention of having achieved remission
203.80 Other immunoproliferative neoplasms without mention of having achieved remission
204.00 Lymphoid leukemia acute without mention of having achieved remission
204.10 Lymphoid leukemia chronic without mentionao of having achieved remission
204.20 Lymphoid leukemia subacute without mention of having achieved remission
204.80 Other lymphoid leukemia without mention of having achieved remission
204.90 Unspecified lymphoid leukemia without mention of having achieved remission
205.00 Myeloid leukemia acute without mention of having achieved remission
205.10 Myeloid leukemia chronic without mention of having achieved remission
205.20 Myeloid leukemia subacute without mention of having achieved remission                                                                                            205.30 Myeloid sarcoma without mention of having achieved remission
205.80 Other myeloid leukemia without mention of having achieved remission
205.90 Unspecified myeloid leukemia without mention of having achieved remission
206.00 Monocyic leukemia acute without mention of having achieved remission
206.10 Monocytic leukemia chronic without mention of having achieved remission
206.20 Monocytic leukemia subacute without mention of having achieved remission
206.80 Other monocytic leukemia without mention of having achieved remission
206.90 Unspecified monocytic leukemia without mention of having achieved remission
207.00 Acute erythremia and erythroleukemia without mention of having achieved remission
207.10 Chronic erythremia without mention of having achieved remission
207.20 Megakaryocytic leukemia without mention of having remission
207.80 Other specified leukemia without mention of having achieved remission
208.00 Leukemia of unspecified cell type acute without mention of having achieved remission
208.10 Leukemia of unspecified cell type chronic without mention of having achieved remission
208.20 Leukemia of unspecified cell type subacute without mention of having achieved remission
208.80 Other leukemia of unspecified cell type without mentino of having achieved remission
208.90 Unspecified leukemia without mention of having achieved remission

• J0641    INJECTION, LEVOLEUCOVORIN CALCIUM, 0.5 MG
• J1453    INJECTION, FOSAPREPITANT, 1 MG
• J1459    INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G.)
• J8705    TOPOTECAN, ORAL, 0.25 MG
• J9033    INJECTION, BENDAMUSTINE HCL, 1 MG
• J9207    INJECTION, IXABEPILONE, 1 MG
• J9330    INJECTION, TEMSIROLIMUS, 1 MG

•  J1572    INJECTION, IMMUNE GLOBULIN, (FLEBOGAMMA/FLEBOGAMMA DIF), INTRAVENOUS,
• J2788    INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, MINIDOSE, 50 MICROGRAMS (250 I.U.)
• J2790    INJECTION, RHO D IMMUNE GLOBULIN, HUMAN, FULL DOSE, 300 MICROGRAMS (1500 I.U.)

• Q4096    INJECTION, VON WILLEBRAND FACTOR COMPLEX, HUMAN, RISTOCETIN COFACTOR (NOT
• Q4097    INJECTION, IMMUNE GLOBULIN (PRIVIGEN), INTRAVENOUS, NON-LYOPHILIZED (E.G.
• Q4098    INJECTION, IRON DEXTRAN, 50 MG

• J1750    INJECTION, IRON DEXTRAN, 50 MG

• HCT level to be less than 30 %
• HGB level to be less than 10 g /dL
• Upper Level of " Exceeds 12 g/dL" is deleted ( withhold dose if hemoglobin exceeds a level needed to avoid transfusion)
• If the Patient is not responsive to the drugs (if the HGB level does not improve by 1 g /dL over a period of 8 weeks), the usage of the drugs should be stopped
• The HCT/HGB level indicated on the claim form should be the most recent
• Medicare will strictly follow the above rules and require that an Informed Consent be obtained from the Patient. Amgen has already placed the above guidelines on the Aranesp label. The benefits and possible ill-effects are to be read to the Patient and their written Consent is to be obtained and maintained with the medical records
• Use EA modifier for chemo induced Anemia
• Use EB modifier for Radiation induced Anemia
• Use EC modifier for Non radiation & Non chemo
• Private carriers will not have uniform policy on ESA’s and it was informed to refer respective websites

As you may recall, earlier this year, we got approval for three new compendia added to Medicare Parts B and Part D off-label coverage for cancer drugs and drug regimens.  They are NCCN, DrugDex, and Gold Standard's Clinical Pharmacology.

The numbering of Hydration and Therapeutic infusions has changed from the "907" series to the "963" series. Examples of changes include:

• 90772 will be 96372
• 90765 will be 96365
• 90767 will be 96367

Part B monthly premiums will not increase in 2009 they'll remain at $96.40. The Part B deductible will remain at $135, as it was in 2008.

Part A which covers hospitalizations has higher deductibles (as it did in 2008). The deductible for 2009 will be $1,068, to be paid by the beneficiary when admitted, according to CMS. This cost is up from $1,024 in 2008.