NGS Code Update New and Revised LCDs and Articles: February 2017

United Rheumatology would like to make you aware of a recent administration code change by the NGS (as of March, 17th, 2017), important for those using Prolia.:
Denosumab (Prolia ™, Xgeva ™) – Related to LCD L33394 (A52399): ICD-10-CM code M81.8 has been added to the Group 2 list of codes in the “Covered ICD-10 Codes” section of the article effective 10/1/2015. Coding guideline #2 in the “Coding Information” section of the article has been revised to change the administration code from 96401 (Chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic) to 96372 (Therapeutic prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular effective for dates of service on or after 3/17/2017. CPT code 96401 has been removed from the “CPTHCPCS Codes” section and CPT code 96372 has been added.
To access the complete article, please follow this link.

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