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Issue 2006-03, March 2006
Instructions for Billing Pegfilgrastim (Neulasta)
Pegfilgrastim (Neulasta) stimulates the formation of white blood cells and is similar to a natural substance in the body, called human gametocyte colony-stimulating factor (G-CSF). Pegfilgrastim (Neulasta) helps the bone marrow recover its ability to produce white blood cells.
The Centers for Medicare and Medicaid Services (CMS) has determined that there have been significant overpayments for the drug Pegfilgrastim (Neulasta) due to the fact that providers are billing this drug with units greater than one.
The correct procedure for billing Pegfilgrastim (Neulasta) 6 mg is as follows:
- Use J2505 Injection, Pegfilgrastim (Neulasta) 6 mg with only 1 unit
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