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Tracking down the correct Medicare LMPR

<huc>Q</huc> I’m trying to find out if Medicare will reimburse for intralesional injections into genital warts (CPT code 11900: Injection, skin intralesional, 1-7 lesions) with interferon alpha-n3.

When I looked this up under the heading “office injectable,” the Medicare carrier policy stated that a diagnosis of genital warts (078.10, Viral warts, unspecified; or 078.19, Viral warts, other specified) was allowed only when billed with intralesional administration of bleomycin.

Is this correct?

<huc>A</huc> This brings up an interesting question: How easy is it to zero in on the correct Medicare local medical policy review (LMPR)?

I’ve found I usually have to search their policy database (www.cms.hhs.gov/mcd/search.asp?) trying several different terms to get the results I need. I usually start with a term that is broad but specific, and then move to terms that are very specific.

Searching for code 11900 would produce too many hits; simply using the phrase “office injectable” is also not specific enough, since it implies intramuscular injections or supplied drugs. In this case, I started with “intralesional injection” and came up with 2 LMPRs. When I entered “interferon alfa-n3” I got 1 hit for Regence Blue Cross/Blue Shield, which indicates the injection is covered.

Following are the policies of 2 Medicare carriers (my notes appear in brackets). Based on these results, it looks like the injection should be covered:

  • AdminaStar Federal policy. Intralesional injection of interferon alfa-n3 [coded using J9215] has been associated with complete or partial resolution of lesions associated with infection by HPV. It is currently indicated for the local treatment of Condylomata acuminate [coded as 078.11]. Coverage will be provided for those applications in which clinical utility has been demonstrated.
  • Cahaba policy. Recombinant interferon alfa-2b, interferon alfa-n1 (1ns), and interferon alfa-n3 are indicated by intralesional injection for treatment of refractory or recurrent external condyloma acuminatum (genital warts).
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Melanie Witt,, RN, CPC, MA
Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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Melanie Witt,, RN, CPC, MA
Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

Author and Disclosure Information

Melanie Witt,, RN, CPC, MA
Ms. Witt, former program manager in the Department of Coding and Nomenclature at the American College of Obstetricians and Gynecologists, is an independent coding and documentation consultant. Reimbursement Adviser reflects the most commonly accepted interpretations of CPT-4 and ICD-9-CM coding. When in doubt on a coding or billing matter, check with your individual payer.

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<huc>Q</huc> I’m trying to find out if Medicare will reimburse for intralesional injections into genital warts (CPT code 11900: Injection, skin intralesional, 1-7 lesions) with interferon alpha-n3.

When I looked this up under the heading “office injectable,” the Medicare carrier policy stated that a diagnosis of genital warts (078.10, Viral warts, unspecified; or 078.19, Viral warts, other specified) was allowed only when billed with intralesional administration of bleomycin.

Is this correct?

<huc>A</huc> This brings up an interesting question: How easy is it to zero in on the correct Medicare local medical policy review (LMPR)?

I’ve found I usually have to search their policy database (www.cms.hhs.gov/mcd/search.asp?) trying several different terms to get the results I need. I usually start with a term that is broad but specific, and then move to terms that are very specific.

Searching for code 11900 would produce too many hits; simply using the phrase “office injectable” is also not specific enough, since it implies intramuscular injections or supplied drugs. In this case, I started with “intralesional injection” and came up with 2 LMPRs. When I entered “interferon alfa-n3” I got 1 hit for Regence Blue Cross/Blue Shield, which indicates the injection is covered.

Following are the policies of 2 Medicare carriers (my notes appear in brackets). Based on these results, it looks like the injection should be covered:

  • AdminaStar Federal policy. Intralesional injection of interferon alfa-n3 [coded using J9215] has been associated with complete or partial resolution of lesions associated with infection by HPV. It is currently indicated for the local treatment of Condylomata acuminate [coded as 078.11]. Coverage will be provided for those applications in which clinical utility has been demonstrated.
  • Cahaba policy. Recombinant interferon alfa-2b, interferon alfa-n1 (1ns), and interferon alfa-n3 are indicated by intralesional injection for treatment of refractory or recurrent external condyloma acuminatum (genital warts).

<huc>Q</huc> I’m trying to find out if Medicare will reimburse for intralesional injections into genital warts (CPT code 11900: Injection, skin intralesional, 1-7 lesions) with interferon alpha-n3.

When I looked this up under the heading “office injectable,” the Medicare carrier policy stated that a diagnosis of genital warts (078.10, Viral warts, unspecified; or 078.19, Viral warts, other specified) was allowed only when billed with intralesional administration of bleomycin.

Is this correct?

<huc>A</huc> This brings up an interesting question: How easy is it to zero in on the correct Medicare local medical policy review (LMPR)?

I’ve found I usually have to search their policy database (www.cms.hhs.gov/mcd/search.asp?) trying several different terms to get the results I need. I usually start with a term that is broad but specific, and then move to terms that are very specific.

Searching for code 11900 would produce too many hits; simply using the phrase “office injectable” is also not specific enough, since it implies intramuscular injections or supplied drugs. In this case, I started with “intralesional injection” and came up with 2 LMPRs. When I entered “interferon alfa-n3” I got 1 hit for Regence Blue Cross/Blue Shield, which indicates the injection is covered.

Following are the policies of 2 Medicare carriers (my notes appear in brackets). Based on these results, it looks like the injection should be covered:

  • AdminaStar Federal policy. Intralesional injection of interferon alfa-n3 [coded using J9215] has been associated with complete or partial resolution of lesions associated with infection by HPV. It is currently indicated for the local treatment of Condylomata acuminate [coded as 078.11]. Coverage will be provided for those applications in which clinical utility has been demonstrated.
  • Cahaba policy. Recombinant interferon alfa-2b, interferon alfa-n1 (1ns), and interferon alfa-n3 are indicated by intralesional injection for treatment of refractory or recurrent external condyloma acuminatum (genital warts).
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