TOP_December 2010_FINAL_TOP 11/17/10 1:06 PM Page 20
ONCOLOGY DRUG CODES Supplied by: RJ Health Systems Continued from page 19
generic (Brand) name
HCPCS code: code description
methylprednisolone (Depo-Medrol)
J1020: injection, methylprednisolone acetate, 20 mg J1030: injection, methylprednisolone acetate, 40 mg J1040: injection, methylprednisolone acetate, 80 mg J2920: injection, methylprednisolone sodium succinate, up to 40 mg J2930: injection, methylprednisolone sodium succinate, up to 125 mg J9265: injection, paclitaxel, 30 mg J3590b: unclassified biologics
methylprednisolone (Depo-Medrol) methylprednisolone (Depo-Medrol) methylprednisolone (Solu-Medrol) methylprednisolone (Solu-Medrol) paclitaxel (Onxol, Taxol) peginterferon alfa-2b (Peg-Intron)
FDAapproved for multiple myeloma
Medicare allowable (ASP + 6%), effective 10/1/10-12/31/10
CPT ® administration codes
✓
$3.78
$2.48
11900, 11901, 20600, 20605, 20610, 96372
✓
$5.22
$4.72
11900, 11901, 20600, 20605, 20610, 96372
✓
$9.52
$8.59
11900, 11901, 20600, 20605, 20610, 96372
✓
$2.36
$1.81
96365, 96366, 96372, 96374
✓
$4.15
$2.54
96365, 96366, 96372, 96374
✓
$15.54
$7.45
96413, 96415
✓
S0148: injection, pegylated interferon alfa-2b, 10 micrograms prednisolone J7510: prednisolone, (Prelone, Millipred) oral, per 5 mg prednisone J7506: prednisone, (Orasone, Deltasone) oral, per 5 mg procarbazine J8999b: prescription drug, (Matulane) oral, chemotherapeutic, not otherwise specified procarbazine S0182: procarbazine HCl, (Matulane) oral, 50 mg
✓
NDC level pricing $116.77
✓
$0.59
NDC level pricing S0148 not payable by Medicare $0.02
✓
$0.04
$0.04
N/A
✓
teniposide (Vumon) thalidomide (Thalomid)
✓
$376.55
NDC level pricing S0182 not payable by Medicare $323.66
N/A
✓
NDC level pricing $55.68
✓
NDC level pricing $1,348.55
NDC level pricing $1,090.84
96413
✓
$5.83
$3.98
96409
✓
$11.66
$7.96
96409
✓
$29.15
$19.90
96409
$263.39
$223.10
peginterferon alfa-2b (Peg-Intron)
topotecan (Hycamtin) vinCRIStine (Vincasar PFS) vinCRIStine (Vincasar PFS) vinCRIStine (Vincasar PFS) zoledronic acid (Zometa)
20
Compendia listed off-label use for multiple myelomaa
Current code price (AWP-based pricing), effective 11/1/10
Q2017: injection, teniposide, 50 mg J8999b: prescription drug, oral, chemotherapeutic, not otherwise specified J9350: injection, topotecan, 4 mg J9370: vincristine sulfate, 1 mg J9375: vincristine sulfate, 2 mg J9380: vincristine sulfate, 5 mg J3487: injection, zoledronic acid (Zometa), 1 mg
December 2010 I VOL 3, NO 8
✓
✓
96372
96372
N/A
N/A
96413, 96415 N/A
96365, 96374
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