SuperCoder Posted Wed 26th of October, 2011 15:53:38 PM
Want to know the billing guidelines associated with Mesna
SuperCoder Answered Wed 26th of October, 2011 15:55:44 PM
Mesna (HCPCS code J9209), is a uroprotective agent in patients who receive oxazaphosphorine alkylating agents including ifosfamide (HCPCS code J9208) and cyclophosphamide (HCPCS code J9070). The active ingredient is a synthetic sulfhydryl compound which is rapidly metabolized to its major metabolite, mesna disulfide. In the kidney, mesna disulfide is reduced to the free thiol compound, mesna which reacts with urotoxic metabolites resulting in their detoxification.
Mesna is indicated for use as a prophylactic agent in reducing the incidence of drug induced hemorrhagic cystitis in patients receiving ifosfamide or cyclophosphamide.
The mesna dosage is 60 percent of the total daily dose of ifosfamide or cyclophosphamide divided into three separate aliquots and administered at the time of, and at four and eight hours after, each dose of chemotherapy. The maximum daily dose of mesna should be 9 gms or 45 units per day. Medical Justification is required to allow more if the cyclophosphamide dose is greater than 6.8 gms or the ifosfamide dose is greater than 15 gms.
Mesna is reimbursable only if billed in conjunction with ifosfamide or cyclophosphamide. CPT-4 code 96375 (therapeutic, prophylactic or diagnostic injection; each additional sequential intravenous push of a new substance/drug) is reimbursable when billed in conjunction with Mesna.
You also have to pick the Primary CPT Codes for 96375 to be used for Chemotherapy as 96375 is an ADD On code from the following lists:
96409: Chemotherapy administration; intravenous, push technique, single or initial substance/drug
96413: Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96416: Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump