Recently someone on the listserv addressed Measure 73 (Plan for Chemotherapy Documented). Is Medicare recognizing Lupron as Chemotherapy in this measure?
Measure 73 requires that a documented plan of chemotherapy is prepared before the chemotherapy regimen is begun. CMS recognizes no specific drugs, but rather the types of cancer and the route of administration of the drugs. Looking at the lists, ICD9 code 185 neoplasm of prostate is included and 96402 and 96409 are included in the procedure list. So it appears that urologists could report this measure for patients newly starting treatment of prostate cancer with drugs such as Lupron, Zoladex, Trelstar, or Eligard administered by IM injection or with other cancer drugs administered by IV infusion. Since the administration of the one year implants are normally billed using a code from the 11000 series, it appears those prostate cancer treatments do not qualify for this measure. If you pardon the pun, it is probably worth a shot to develop some sort of chemotherapy plan template to include in the patient’s record. If you complete this plan for a patient just starting chemotherapy, you wou
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