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National
Government Services Medical Policy Revision for: Drugs and Biologicals,
Coverage of, for Label and Off Label Uses
LCD and Coverage Articles Part A & B Effective January 1, 2009
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LCD for Drugs and
Biologicals, Coverage of, for Label and Off-Label Uses (L25820)
R5* (effective 01/01/2009); Internal; the LCD has been revised to
include compendia recognized by CMS based on Change Request 6191
(Compendia as Authoritative Sources for Use in the Determination of a
Medically Accepted Indication of Drugs and Biologicals Used Off-Label in
an Anti-Cancer Chemotherapeutic Regimen. Added Internet Only Manual
(IOM) language to the “Limitations” section. The following articles
have been added: A48208 - Filgrastim, Pegfilgrastim (e.g., Neupogen®,
Neulasta TM), A48339 – Floxuridine, A48211 - Thyrotropin Alfa (Thyrogen®)
and A48213 - Vitamin B-12 Injections. The following article has been
retired: A46093 – Rituximab (Rituxan®). Minor changes were made to
reflect current template language. Although revision R5 is effective
01/01/2009, the addition of the compendia based on Change Request 6191
is effective 11/25/2008. No notice period required and none given. |
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