CMS Update: Q2043 Covers More Services Than You May Expect, Says CMS

You'll also want to highlight the need for a second ICD-9 code.

A recent Medicare announcement revealed the limits of Provenge coverage. Here are the specifics.

Resist Urge to Report Q2043 With Admin Code

CMS announced coverage for Provenge use, finding the immunotherapy reasonable and necessary for beneficiaries with \asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone refractory) prostate cancer." The effective date is June 30, 2011, and the implementation date is Aug. 8, 2011.

HCPCS: As of July 1, a new code for Provenge is available: Q2043 (Sipuleucel-T, minimum of 50 million autologous CD54+ cells activated with PAP-GM-CSF, including leukapheresis and all other [...]

- Published on 2011-08-05