Medications Used for the Treatment of Cervical CancerCervical cancer forms in tissues of the cervix(the organ connecting the uterus and vagina).It is usually a slow-growing cancer that may nothave symptoms but can be found with regularPap tests. Cervical cancer is almost alwayscaused by human papillomavirus (HPV) infec-tion. The following sections will assist health-care professionals and payers by providingappropriate coding, billing, and reimbursementinformation associated with the management ofcervical cancer.

The following sections include:• Associated ICD-9-CM codes used for the

classification of cervical cancer• Drugs that have been FDA-approved in

the treatment of cervical cancer. Please note: if a check mark appears in the FDA column it will NOT appear in the Compendia section even if a drug is included in the NCCN (National Comprehensive Cancer Network) Drugs & Biologics Compendium

• Drugs included in the NCCN Drugs & Biologics Compendium for off-label use in cervical cancer. NCCN is recognized by CMS (Centers for Medicare & Medicaid Services) as a referencing source

• Corresponding HCPCS/CPT Codes and Code Descriptions

• Current Code Price (AWP-based pricing)• Most recent ASP plus 6% (Medicare

allowable)• Possible CPT Administration Codes for

each medication

Associated ICD-9-CM Codes Used for Cervical Cancer180 Malignant neoplasm of cervix uteri

Includes: invasive malignancy [carcinoma]Excludes: carcinoma in situ (233.1)

180.0 EndocervixCervical canal, not otherwise specifiedEndocervical canalEndocervical gland

180.1 Exocervix180.8 Other specified sites of cervix

Cervical stumpSquamocolumnar junction of cervixMalignant neoplasm of contiguous or overlapping sites of cervix uteri whose point of origin cannot be determined

180.9 Cervix uteri, unspecified

233 Carcinoma in situ of breast and genitourinary system233.1 Cervix uteri

Adenocarcinoma in situ of cervixCervical intraepithelial glandular neoplasia, > grade III <Cervical intraepithelial neoplasia III [CIN III]Severe dysplasia of cervixExcludes: cervical intraepithelial neoplasia II [CIN II] (622.12)

cytologic evidence of malignancy without histologic confirmation(795.06)high-grade squamous intraepithelial lesion (HGSIL) (795.04)moderate dysplasia of cervix (622.12)

NCCN Drugs Current MedicareFDA- & Biologics code price allowableapproved Compendium (AWP-based (ASP + 6%), CPT

generic (Brand) HCPCS code: for cervical off-label use for pricing), effective effective administrationname code description cancer cervical cancer 1/10/10 1/10/10-3/31/10 codes

bevacizumab J9035: injection, $66.99 $57.46 96413, 96415(Avastin) bevacizumab, 10 mgbleomycin J9040: injection, $45.30 $28.47 96401, 96409(Blenoxane) bleomycin sulfate, 15 unitscarboplatin J9045: injection, $85.10 $4.84 96409, 96413, 96415(Paraplatin) carboplatin, 50 mgcisplatin J9060: cisplatin, $4.33 $2.08 96409, 96413, 96415(Platinol AQ) powder or solution, per 10 mgcisplatin J9062: cisplatin, $21.66 $10.41 96409, 96413, 96415(Platinol AQ) 50 mgdocetaxel J9171: injection, $23.23 $17.62 96413(Taxotere) docetaxel, 1 mgdoxorubicin HCl J9001: injection, $559.32 $471.38 96413liposome doxorubicin hydrochloride, (Doxil) all lipid formulations, 10 mgepirubicin J9178: injection, $8.16 $2.65 96409, 96413(Ellence) epirubicin HCl, 2 mg

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O N C O L O G Y D R U G C O D E SSupplied by: RJ Health Systems

NCCN Drugs Current MedicareFDA- & Biologics code price allowableapproved Compendium (AWP-based (ASP + 6%), CPT

generic (Brand) HCPCS code: for cervical off-label use for pricing), effective effective administrationname code description cancer cervical cancer 1/10/10 1/10/10-3/31/10 codes

fluorouracil J9190: injection, $3.30 $1.60 96409(Adrucil) fluorouracil, 500 mggemcitabine J9201: injection, gemcitabine $169.46 $144.93 96413(Gemzar) hydrochloride, 200 mgifosfamide J9208: injection, $56.40 $30.08 96413, 96415(Ifex) ifosfamide, 1 gramirinotecan J9206: injection, $84.71 $6.94 96413, 96415(Camptosar) irinotecan, 20 mgmesna J9209: injection, $10.44 $4.64 96409(Mesnex) mesna, 200 mgmitomycin J9280: mitomycin, $67.20 $17.15 96409(Mutamycin) 5 mgmitomycin J9290: mitomycin, $218.40 $68.60 96409(Mutamycin) 20 mgmitomycin J9291: mitomycin, $300.00 $137.19 96409(Mutamycin) 40 mgpaclitaxel J9265: injection, $17.70 $9.44 96413, 96415(Taxol, Onxol) paclitaxel, 30 mgpemetrexed J9305: injection, $59.25 $50.59 96409(Alimta) pemetrexed, 10 mgtopotecan J9350: injection, $1264.99 $1031.91 96413(Hycamtin) topotecan, 4 mgvinorelbine J9390: injection, $42.60 $11.59 96409(Navelbine) vinorelbine tartrate,

per 10 mg

References• HCPCS Level II Expert 2010 • CPT 2010 • ICD-9-CM for Professionals Volumes 1 & 2; 2010 • The Drug Reimbursement Coding and Pricing Guide, Vol 7, No 1; RJ Health Systems International LLC;1st Quarter 2010 • FDA-approved indication (from products’ prescribing information) • The NCCN Drugs & Biologics Compendium™ © 2010 National Comprehensive Cancer Network, Inc. Availableat: http://www.ncc.org. Accessed [January 1, 2010]. To view the most recent and complete version of The NCCN Compendium, go online to www.nccn.org • National Cancer Institute •www.ReimbursementCodes.com powered by RJ Health Systems International, LLC, Wethersfield, Connecticut • CMS-Medicare allowable 1st Quarter 2010 (effective dates 1/1/10-3/31/10).

Prices listed herein are effective as of January 1, 2010.

ASP indicates average sales price; AWP, average wholesale price; CMS, Centers for Medicare & Medicaid Services; CPT, Current Procedural Terminology; FDA, US Food and Drug Administration; HCPCS,Healthcare Common Procedure Coding System; NCCN, National Comprehensive Cancer Network.

This information was supplied by:

PO BOX 290616, Wethersfield, CT 06109 T: (860) 563-1223F: (860) 563-1650

www.RJHealthSystems.com

2010 UPDATES OF THE HEALTHCARE COMMON PROCEDURE

CODING SYSTEM (HCPCS)Effective: January 1, 2010

NewC9257: injection, bevacizumab, 0.25 mg (Avastin)J9155: injection, degarelix, 1 mg (Firmagon)J9171: injection, docetaxel, 1 mg (Taxotere)J9328: injection, temozolomide, 1 mg (Temodar)DeletedQ2024: injection, bevacizumab, 0.25 mg

(code deleted effective 1/1/10; see C9257 and J9035)J9170: injection, docetaxel, 20 mg

(code deleted effective 1/1/10; see J9171)C9253: injection, temozolomide, 1 mg

(code deleted effective 1/1/10; see J9328)

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O N C O L O G Y D R U G C O D E SSupplied by: RJ Health Systems