LCD : Carboplatin (L20721)

LCD for Carboplatin (L20721)

Contractor Information

Contractor Name ^{back to top}
BlueCross BlueShield of Tennessee (Riverbend Government Benefits Administrator)
Contractor Number ^{back to top}
00390
Contractor Type ^{back to top}
FI

LCD Information

LCD ID Number ^{back to top}
L20721

LCD Title ^{back to top}
Carboplatin

Contractor's Determination Number ^{back to top}
L20721

AMA CPT / ADA CDT Copyright Statement ^{back to top}
CPT codes, descriptions and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. � 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

CMS National Coverage Policy ^{back to top}
Title XVIII of the Social Security Act, Section 1862(a)(7). This section excludes routine physical examinations. Title XVIII of the Social Security Act, Section 1862(a)(1)(A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury. Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider for any claim that lacks the necessary information to process the claim. CMS On-line Manual Pub. 100-2, Chapter 15, Sections 50, 60 CMS On-line Manual Pub. 100-2, Chapter 17, Section 10 CMS On-line Manual Pub. 100-4, Chapter 12, Section 30.5

Primary Geographic Jurisdiction ^{back to top}
New Jersey Tennessee

Secondary Geographic Jurisdiction ^{back to top}
Alaska Alabama Arkansas Arizona California Colorado Connecticut Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi North Carolina North Dakota Nebraska New Mexico Nevada Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Oversight Region ^{back to top}
Region IV


Original Determination Effective Date ^{back to top}
For services performed on or after 09/30/2005

Original Determination Ending Date ^{back to top}


Revision Effective Date ^{back to top}
For services performed on or after 04/20/2006

Revision Ending Date ^{back to top}


Indications and Limitations of Coverage and/or Medical Necessity ^{back to top}
Carboplatin is a platinum coordination compound that is used as a cancer chemotherapeutic agent. Although the exact mechanism of action is unknown, action is thought to be similar to that of the bifunctional alkylating agents, that is, possible cross-linking and interference with the function of DNA. It is cell cycle-phase non-specific. Indications Carboplatin may be indicated for use in the following: ovarian and endometrial carcinoma small cell and non-small cell lung carcinoma head and neck tumors nonseminomatous testicular carcinoma seminoma retinoblastoma primary brain tumors malignant melanoma osteogenic and soft tissue sarcomas prostate, bladder and urothelial malignancies breast carcinomas esophageal carcinoma and adenocarcinoma carcinoma of unknown primary site fallopian tube and peritoneal carcinomas (of ovarian origin) Hodgkin's and non-Hodgkin's lymphomas transitional cell carcinoma of the urethra, ureter and kidney malignant mesothelioma cervical carcinomas and carcinoma of female genital organs Limitations It is recommended that Carboplatin be administered to patients under supervision of a physician experienced in cancer chemotherapy. It is also, recommended that equipment and medications (including epinephrine, oxygen, antihistamines and intravenous corticosteroids) necessary for treatment of a possible anaphylactic reaction be readily available each administration of carboplatin. Payment for the drug and associated services (i.e., rescue agents, chemotherapy) will be denied as not medically necessary (investigational) when used for a disease process not listed above. Therefore claims reported with an ICD-9 code not listed in the �ICD-9 Codes That Support Medical Necessity� section of this policy will be denied. However, because cancer therapy is rapidly evolving and chemotherapeutic protocol evaluation is part of routine care, those claims may be reversed on appeal IF the drug is administered under a formal protocol conducted under the auspices of a National Cancer Center of Excellence. That documentation would be required on appeal.

Coverage Topic ^{back to top}
Chemotherapy (Outpatient) Outpatient Hospital Services

Coding Information

Bill Type Codes: ^{back
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Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

Revenue Codes: ^{back
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Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

0636	Drugs requiring specific identification-detailed coding (eff 3/92)

CPT/HCPCS Codes ^{back
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J9045

CARBOPLATIN, 50 MG

ICD-9 Codes that Support Medical Necessity ^{back
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140.0 - 140.1	MALIGNANT NEOPLASM OF UPPER LIP VERMILION BORDER - MALIGNANT NEOPLASM OF LOWER LIP VERMILION BORDER
140.3 - 140.6	MALIGNANT NEOPLASM OF UPPER LIP INNER ASPECT - MALIGNANT NEOPLASM OF COMMISSURE OF LIP
140.8 - 140.9	MALIGNANT NEOPLASM OF OTHER SITES OF LIP - MALIGNANT NEOPLASM OF LIP UNSPECIFIED VERMILION BORDER
141.0 - 141.6	MALIGNANT NEOPLASM OF BASE OF TONGUE - MALIGNANT NEOPLASM OF LINGUAL TONSIL
141.8 - 141.9	MALIGNANT NEOPLASM OF OTHER SITES OF TONGUE - MALIGNANT NEOPLASM OF TONGUE UNSPECIFIED
142.0 - 142.2	MALIGNANT NEOPLASM OF PAROTID GLAND - MALIGNANT NEOPLASM OF SUBLINGUAL GLAND
142.8 - 142.9	MALIGNANT NEOPLASM OF OTHER MAJOR SALIVARY GLANDS - MALIGNANT NEOPLASM OF SALIVARY GLAND UNSPECIFIED
143.0 - 143.1	MALIGNANT NEOPLASM OF UPPER GUM - MALIGNANT NEOPLASM OF LOWER GUM
143.8 - 143.9	MALIGNANT NEOPLASM OF OTHER SITES OF GUM - MALIGNANT NEOPLASM OF GUM UNSPECIFIED
144.0 - 144.1	MALIGNANT NEOPLASM OF ANTERIOR PORTION OF FLOOR OF MOUTH - MALIGNANT NEOPLASM OF LATERAL PORTION OF FLOOR OF MOUTH
144.8 - 144.9	MALIGNANT NEOPLASM OF OTHER SITES OF FLOOR OF MOUTH - MALIGNANT NEOPLASM OF FLOOR OF MOUTH PART UNSPECIFIED
145.0 - 145.6	MALIGNANT NEOPLASM OF CHEEK MUCOSA - MALIGNANT NEOPLASM OF RETROMOLAR AREA
145.8 - 145.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED PARTS OF MOUTH - MALIGNANT NEOPLASM OF MOUTH UNSPECIFIED
146.0 - 146.9	MALIGNANT NEOPLASM OF TONSIL - MALIGNANT NEOPLASM OF OROPHARYNX UNSPECIFIED SITE
147.0 - 147.3	MALIGNANT NEOPLASM OF SUPERIOR WALL OF NASOPHARYNX - MALIGNANT NEOPLASM OF ANTERIOR WALL OF NASOPHARYNX
147.8 - 147.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF NASOPHARYNX - MALIGNANT NEOPLASM OF NASOPHARYNX UNSPECIFIED SITE
148.0 - 148.3	MALIGNANT NEOPLASM OF POSTCRICOID REGION OF HYPOPHARYNX - MALIGNANT NEOPLASM OF POSTERIOR HYPOPHARYNGEAL WALL
148.8 - 148.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF HYPOPHARYNX - MALIGNANT NEOPLASM OF HYPOPHARYNX UNSPECIFIED SITE
149.0 - 149.1	MALIGNANT NEOPLASM OF PHARYNX UNSPECIFIED - MALIGNANT NEOPLASM OF WALDEYER'S RING
149.8 - 149.9	MALIGNANT NEOPLASM OF OTHER SITES WITHIN THE LIP AND ORAL CAVITY - MALIGNANT NEOPLASM OF ILL-DEFINED SITES WITHIN THE LIP AND ORAL CAVITY
150.0 - 150.5	MALIGNANT NEOPLASM OF CERVICAL ESOPHAGUS - MALIGNANT NEOPLASM OF LOWER THIRD OF ESOPHAGUS
150.8 - 150.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED PART OF ESOPHAGUS - MALIGNANT NEOPLASM OF ESOPHAGUS UNSPECIFIED SITE
151.0	MALIGNANT NEOPLASM OF CARDIA
158.8	MALIGNANT NEOPLASM OF SPECIFIED PARTS OF PERITONEUM
160.0 - 160.5	MALIGNANT NEOPLASM OF NASAL CAVITIES - MALIGNANT NEOPLASM OF SPHENOIDAL SINUS
160.8 - 160.9	MALIGNANT NEOPLASM OF OTHER ACCESSORY SINUSES - MALIGNANT NEOPLASM OF ACCESSORY SINUS UNSPECIFIED
161.0 - 161.3	MALIGNANT NEOPLASM OF GLOTTIS - MALIGNANT NEOPLASM OF LARYNGEAL CARTILAGES
161.8 - 161.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF LARYNX - MALIGNANT NEOPLASM OF LARYNX UNSPECIFIED
162.0	MALIGNANT NEOPLASM OF TRACHEA
162.2 - 162.5	MALIGNANT NEOPLASM OF MAIN BRONCHUS - MALIGNANT NEOPLASM OF LOWER LOBE BRONCHUS OR LUNG
162.8 - 162.9	MALIGNANT NEOPLASM OF OTHER PARTS OF BRONCHUS OR LUNG - MALIGNANT NEOPLASM OF BRONCHUS AND LUNG UNSPECIFIED
163.0 - 163.9	MALIGNANT NEOPLASM OF PARIETAL PLEURA - MALIGNANT NEOPLASM OF PLEURA UNSPECIFIED
170.0 - 170.9	MALIGNANT NEOPLASM OF BONES OF SKULL AND FACE EXCEPT MANDIBLE - MALIGNANT NEOPLASM OF BONE AND ARTICULAR CARTILAGE SITE UNSPECIFIED
171.0	MALIGNANT NEOPLASM OF CONNECTIVE AND OTHER SOFT TISSUE OF HEAD FACE AND NECK
171.2 - 171.9	MALIGNANT NEOPLASM OF CONNECTIVE AND OTHER SOFT TISSUE OF UPPER LIMB INCLUDING SHOULDER - MALIGNANT NEOPLASM OF CONNECTIVE AND OTHER SOFT TISSUE SITE UNSPECIFIED
172.0 - 172.9	MALIGNANT MELANOMA OF SKIN OF LIP - MELANOMA OF SKIN SITE UNSPECIFIED
174.0 - 174.6	MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST - MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST
174.8 - 174.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST - MALIGNANT NEOPLASM OF BREAST (FEMALE) UNSPECIFIED SITE
175.0	MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF MALE BREAST
175.9	MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED SITES OF MALE BREAST
180.0 - 180.9	MALIGNANT NEOPLASM OF ENDOCERVIX - MALIGNANT NEOPLASM OF CERVIX UTERI UNSPECIFIED SITE
182.0	MALIGNANT NEOPLASM OF CORPUS UTERI EXCEPT ISTHMUS
183.0	MALIGNANT NEOPLASM OF OVARY
183.2 - 183.5	MALIGNANT NEOPLASM OF FALLOPIAN TUBE - MALIGNANT NEOPLASM OF ROUND LIGAMENT OF UTERUS
183.8 - 183.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF UTERINE ADNEXA - MALIGNANT NEOPLASM OF UTERINE ADNEXA UNSPECIFIED SITE
184.0 - 184.9	MALIGNANT NEOPLASM OF VAGINA - MALIGNANT NEOPLASM OF FEMALE GENITAL ORGAN SITE UNSPECIFIED
185	MALIGNANT NEOPLASM OF PROSTATE
186.0	MALIGNANT NEOPLASM OF UNDESCENDED TESTIS
186.9	MALIGNANT NEOPLASM OF OTHER AND UNSPECIFIED TESTIS
188.0 - 188.9	MALIGNANT NEOPLASM OF TRIGONE OF URINARY BLADDER - MALIGNANT NEOPLASM OF BLADDER PART UNSPECIFIED
189.0 - 189.4	MALIGNANT NEOPLASM OF KIDNEY EXCEPT PELVIS - MALIGNANT NEOPLASM OF PARAURETHRAL GLANDS
189.8 - 189.9	MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF URINARY ORGANS - MALIGNANT NEOPLASM OF URINARY ORGAN SITE UNSPECIFIED
190.5	MALIGNANT NEOPLASM OF RETINA
191.0 - 191.9	MALIGNANT NEOPLASM OF CEREBRUM EXCEPT LOBES AND VENTRICLES - MALIGNANT NEOPLASM OF BRAIN UNSPECIFIED SITE
193	MALIGNANT NEOPLASM OF THYROID GLAND
194.1	MALIGNANT NEOPLASM OF PARATHYROID GLAND
194.3 - 194.5	MALIGNANT NEOPLASM OF PITUITARY GLAND AND CRANIOPHARYNGEAL DUCT - MALIGNANT NEOPLASM OF CAROTID BODY
194.8 - 194.9	MALIGNANT NEOPLASM OF OTHER ENDOCRINE GLANDS AND RELATED STRUCTURES - MALIGNANT NEOPLASM OF ENDOCRINE GLAND SITE UNSPECIFIED
195.0	MALIGNANT NEOPLASM OF HEAD FACE AND NECK
196.0	SECONDARY AND UNSPECIFIED MALIGNANT NEOPLASM OF LYMPH NODES OF HEAD FACE AND NECK
197.0	SECONDARY MALIGNANT NEOPLASM OF LUNG
197.3	SECONDARY MALIGNANT NEOPLASM OF OTHER RESPIRATORY ORGANS
197.6	SECONDARY MALIGNANT NEOPLASM OF RETROPERITONEUM AND PERITONEUM
197.8	SECONDARY MALIGNANT NEOPLASM OF OTHER DIGESTIVE ORGANS AND SPLEEN
198.1	SECONDARY MALIGNANT NEOPLASM OF OTHER URINARY ORGANS
198.6	SECONDARY MALIGNANT NEOPLASM OF OVARY
198.81	SECONDARY MALIGNANT NEOPLASM OF BREAST
198.82	SECONDARY MALIGNANT NEOPLASM OF GENITAL ORGANS
198.89	SECONDARY MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES
199.0 - 199.1	DISSEMINATED MALIGNANT NEOPLASM - OTHER MALIGNANT NEOPLASM OF UNSPECIFIED SITE
201.00 - 201.98	HODGKIN'S PARAGRANULOMA UNSPECIFIED SITE - HODGKIN'S DISEASE UNSPECIFIED TYPE INVOLVING LYMPH NODES OF MULTIPLE SITES
202.80 - 202.88	OTHER MALIGNANT LYMPHOMAS UNSPECIFIED SITE - OTHER MALIGNANT LYMPHOMAS INVOLVING LYMPH NODES OF MULTIPLE SITES
235.0 - 235.1	NEOPLASM OF UNCERTAIN BEHAVIOR OF MAJOR SALIVARY GLANDS - NEOPLASM OF UNCERTAIN BEHAVIOR OF LIP ORAL CAVITY AND PHARYNX
235.5 - 235.7	NEOPLASM OF UNCERTAIN BEHAVIOR OF OTHER AND UNSPECIFIED DIGESTIVE ORGANS - NEOPLASM OF UNCERTAIN BEHAVIOR OF TRACHEA BRONCHUS AND LUNG
236.2 - 236.5	NEOPLASM OF UNCERTAIN BEHAVIOR OF OVARY - NEOPLASM OF UNCERTAIN BEHAVIOR OF PROSTATE
236.7	NEOPLASM OF UNCERTAIN BEHAVIOR OF BLADDER
236.90	NEOPLASM OF UNCERTAIN BEHAVIOR OF URINARY ORGAN UNSPECIFIED
238.3	NEOPLASM OF UNCERTAIN BEHAVIOR OF BREAST
239.0	NEOPLASM OF UNSPECIFIED NATURE OF DIGESTIVE SYSTEM
239.1	NEOPLASM OF UNSPECIFIED NATURE OF RESPIRATORY SYSTEM
239.3	NEOPLASM OF UNSPECIFIED NATURE OF BREAST
239.4	NEOPLASM OF UNSPECIFIED NATURE OF BLADDER
239.5	NEOPLASM OF UNSPECIFIED NATURE OF OTHER GENITOURINARY ORGANS

Diagnoses that Support Medical Necessity ^{back
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ICD-9 Codes that DO NOT Support Medical Necessity ^{back
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ICD-9 Codes that DO NOT Support Medical Necessity Asterisk Explanation ^{back
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Diagnoses that DO NOT Support Medical Necessity ^{back
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Any ICD-9 code not listed under the "ICD-9 Codes That Support Medical Necessity" section of this policy.

General Information

Documentation Requirements ^{back
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Documentation in the medical record must contain a history and physical pertinent to the indications of this policy. In addition the documentation must support the medical necessity and frequency for administration of this agent.

Carboplatin is not Medicare-covered in cancers where the effectiveness has not been demonstrated. However cancer therapy is a constantly evolving discipline. Therefore, if this agent MAY be covered if used for a patient participating in a protocol under the oversight of a National Cancer Center for Excellence. Documentation would be required on appeal to support the patient's inclusion in the protocol and demonstrate that the facility is an affiliate of the Cancer Center with respect to the protocol.

When a portion of the drug is discarded, the medical record must clearly document the amount administered and the amount wasted. The medical record must be available to the Intermediary upon request.

Appendices ^{back
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LINK TO QUESTIONS AND ANSWERS (COMMENTS) ABOUT THIS
POLICY:
Frequently Asked Questions

Utilization Guidelines ^{back
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Utilization of these services should be consistent with the established chemotherapeutic protocols of recognized Cancer centers. Riverbend will consider such protocols to define the locally acceptable standards of practice.

Sources of Information and Basis for Decision ^{back
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Hainsworth JD, Burris HA, Meluch AA, et. al: Paclitaxel, Carboplatin, and Long-Term Continuous Infusion of 5-Flurouracil in the Treatment of Advanced Squamous and Other Selected Carcinomas. Cancer. 2001 Aug;92(3):642-9.

Sirotnak FM, Zakowski MF, Miller VA, et. al: Efficacy of Cytotoxic Agents Against Human Tumor Xenografts is Markedly Enhanced by Coadministration of ZD1839 (Iressa), an Inhibitor of EGFR Tyrosine Kinase. Clinical Cancer Research. 2000 Dec;6:4885-92.

Ishikawa H, Kikkawa F, Tamakoshi K, et. al: Distribution of Platinum in Human Gynecologic Tissues and Lymph Nodes after Intravenous and Intraarterial Neoadjuvant Chemotherapy. Anticancer Research. 1996 July;16:3849-54.

USP DI. Carboplatin. 2002.

USP DI Oncology Drug Information 2nd Edition 1998-1999, pages 77-81

Pycha A, Grbovic M, Posch B, et. al: Paclitaxel And Carboplatin In Patients With Metastatic Transitional Cell Cancer Of The Urinary Tract. Urology. 1999 Mar;53(3):510-5.

Edelman MJ, Meyers FJ, Miller TR, et. al: Phase I/II Study Of Paclitaxel, Carboplatin, And Methotrexate In Advanced Transitional Cell Carcinoma: A Well-Tolerated Regimen With Activity Independent Of P53 Mutation. Urology. 2000 Apr;55(4):521-5.

Hussain M, Vaishampayan U, Du W, et. al: Combination Paclitaxel, Carboplatin, And Gemcitabine Is An Active Treatment For Advanced Urothelial Cancer. J Clin Oncol. 2001 May 1;19(9):2527-33.

Carles J, Nogue M. Gemcitabine/Carboplatin In Advanced Urothelial Cancer. Semin Oncol. 2001 Jun;28(3 Suppl 10):19-24. Review.

Shannon C, Crombie C, Brooks A, et. al: Carboplatin And Gemcitabine In Metastatic Transitional Cell Carcinoma Of The Urothelium: Effective Treatment Of Patients With Poor Prognostic Features. Ann Oncol. 2001 Jul;12(7):947-52.

Moskowitz CH, Nimer SD, Zelenetz AD, et al: A 2-Step Comprehensive High-Dose Chemoradiotherapy Second-Line Program For Relapsed And Refractory Hodgkin Disease: Analysis By Intent To Treat And Development Of A Prognostic Model. Blood 2001 Feb 1;97(3):616-23

Moskowitz CH, Bertino JR, Glassman JR, et al: Ifosfamide, Carboplatin, And Etoposide: A Highly Effective Cytoreduction And Peripheral-Blood Progenitor-Cell Mobilization Regimen For Transplant-Eligible Patients With Non-Hodgkin's Lymphoma. J Clin Oncol 1999 Dec;17(12):3776-85

Richardson DS, Tighe M, Cull G, Johnson SA, Phillips MJ. Salvage Chemotherapy For Relapsed And Resistant Lymphoma With A Carboplatin Containing Schedule--EPIC. Hematol Oncol 1994 May-Jun;12(3):125-8

Niitsu N, Umeda M. Salvage Chemotherapy For Relapsed Or Refractory Non-Hodgkin's Lymphoma With A Combination Of ACES (High-Dose Ara C, Carboplatin, Etoposide And Steroids) Therapy. Eur J Haematol 1996 Oct;57(4):320-4

Fontelonga A, Kelly AJ, MacKintosh FR, et al: A Novel High-Dose Chemotherapy Protocol With Autologous Hematopoietic Rescue In Patients With Metastatic Breast Cancer Or Recurrent Non-Hodgkin's Lymphoma. Bone Marrow Transplant 1997 May;19(10):983-8

Raghavan D, Gianoutsos P, Bishop J, et al: Phase II Trial Of Carboplatin In The Management Of Malignant Mesothelioma. J Clin Oncol. 1990 Jan;8(1):151-4.

Shukunami K, Hirabuki S, Kaneshima M, et al: Well-Differentiated Papillary Mesothelioma Involving The Peritoneal And Pleural Cavities: Successful Treatment By Local And Systemic Administration Of Carboplatin. Tumori. 2000 Sep-Oct;86(5):419-21.

Vogelzang NJ, Goutsou M, Corson JM, et al: Carboplatin In Malignant Mesothelioma: A Phase II Study Of The Cancer And Leukemia Group B.

Cancer Chemother Pharmacol. 1990;27(3):239-42.

USP DI Oncology Drug Information Update - January 2001, September 2001

Physicians� Desk Reference 53rd Edition 1999, pages 789-792

National Cancer Institute publication "Osteosarcoma/Malignant Fibrous Histiocytoma of Bone" accessed April 28, 2000 from http://cancernet.nci.nih.gov.

Other carriers� policies � Pennsylvania

Manufacturers' drug package insert

Advisory Committee Meeting Notes ^{back
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This policy does not reflect the sole opinion of the contractor or contractor medical director. Although the final decision rests with the contractor, this policy was developed in cooperation with advisory groups, which includes representatives from cancer treatment facilities.

Start Date of Comment Period ^{back
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06/29/2005

End Date of Comment Period ^{back
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08/13/2005

Start Date of Notice Period ^{back
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08/15/2005

Revision History Number ^{back
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20721b

Revision History Explanation ^{back
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Removed Revenue codes 0250,0331,0335, 0500,0550
Added Revenue code 0636 on 04/20/2006

Last Reviewed On Date ^{back
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06/21/2007