Member Policies - Medical Policies - Alabama

Current Provider-Administered Oncology Drug Policies

Kanjinti: See VP-0057 below.

Kymriah: For dates of service on or after January 1, 2019, through December 31, 2020, providers or facilities need to send requests and/or claims to Original Medicare. See Decision Memo for Chimeric Antigen Receptor (CAR) T-cell Therapy for Cancers (CAG-00451N).

Nyvepria: See VP-0234 below.

Trazimera: See VP-0057 below.

Yescarta: For dates of service on or after January 1, 2019, through December 31, 2020, providers or facilities need to send requests and/or claims to Original Medicare. See Decision Memo for Chimeric Antigen Receptor (CAR) T-cell Therapy for Cancers (CAG-00451N).

Ziextenzo: See VP-0234 below.

For billing and coding for Rituximab, refer to LCD L35026/Article A56380 for the following drugs:

For billing and coding for chemotherapy, refer to Palmetto article A56141 for the following drugs:

For white cell colony stimulating factors, refer to LCD L37176/A56748 for the following drugs: