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| Billing Reminder: Oral Anti-Cancer Drug – Topotecan National Government Services, the Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor (DME MAC) has received several questions regarding how claims should be submitted for the oral anti-cancer drug topotecan. Suppliers have been instructed that all covered oral anti-cancer drugs with a valid NDC number on the Medicare Pricing, Data Analysis and Coding Contractor (PDAC) Web site must be billed to the DME MACs with the correct NDC code. Recently, the PDAC added a new code to the Oral Anti-Cancer Drug (OACD) quarterly update list for topotecan, however, this addition was premature and the new code is not effective until July 2009. Therefore, the PDAC has updated the OACD quarterly update list to remove the recently added NDC number for topotecan. Suppliers should continue billing claims for topotecan to all of the DME MACs using HCPCS code J8999 as they have in the past. Suppliers submitting claims with the J8999 HCPCS code must also provide the drug name, the amount given (number of tablets or capsules dispensed), manufacturer and NDC number in the NTE segment (Note segment) of the electronic claim, or item 19 of the CMS-1500 paper claim. Suppliers should continue to check the Oral Anti-Cancer Drug (OACD) quarterly update list on the PDAC Web site for updates, and can begin submitting claims with the applicable NDC once effective. The OACD quarterly update list is located at: www.dmepdac.com. |
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