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DOXILine.com Reimbursement Excellence Centocor Ortho Biotech Inc.
Introduction Medicare Guideline Archives Medicare Guideline Update Table

State Medicare Guidelines / CMS 1500
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BILLING & REIMBURSEMENT

Medicare Guideline Update Table

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A

Alabama

Part A - Updated May 18, 2009

Part B - Updated February 01, 2010

Alaska

Part A - Updated June 09, 2009

Part B - Updated February 26, 2009

Arizona

Part A - Updated June 09, 2009

Part B - Updated December 09, 2008

Arkansas

Part A - Updated December 15, 2009

Part B - Updated December 15, 2009
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C

California

Part A - Updated February 26, 2009

Part B - Updated February 26, 2009

Colorado

MAC - Updated December 31, 2009

Connecticut

Part A - Updated August 01, 2009

Part B - Updated August 01, 2009
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D

Delaware

MAC - Updated January 14, 2010

District of Columbia

MAC - Updated January 14, 2010
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F

Florida

Part A - Updated February 16, 2009

Part B - Updated February 02, 2009
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G

Georgia

Part A - Updated May 04, 2009

Part B - Updated February 01, 2010
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H

Hawaii

Part A - Updated February 26, 2009

Part B - Updated February 26, 2009
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I

Idaho

Part A - Updated June 09, 2009

Part B - Updated October 01, 2009

Illinois

Part A - Updated August 01, 2009

Part B - Updated February 01, 2010

Indiana

Part A - Updated August 01, 2009

Part B - Updated August 01, 2009

Iowa

Part A - Updated February 01, 2010

Part B - Updated February 01, 2010
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K

Kansas

Part A - Updated February 01, 2010

Part B - Updated February 01, 2010

Kentucky

Part A - Updated August 01, 2009

Part B - Updated August 01, 2009
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L

Louisiana

Part A - Updated January 01, 2006

Part B - Updated December 15, 2009
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M

Maine

Part A - Updated May 15, 2009

Part B - Updated June 01, 2009

Maryland

MAC - Updated January 14, 2010

Massachusetts

Part A - Updated May 15, 2009

Part B - Updated June 01, 2009

Michigan

Part A - Updated August 01, 2009

Part B - Updated February 01, 2010

Minnesota

Part A - Updated June 09, 2009

Part B - Updated February 01, 2010

Mississippi

Part A - Updated January 01, 2006

Part B - Updated February 01, 2010

Missouri

Part A - Updated February 01, 2010

Part B - Updated February 01, 2010

Montana

Part A - Updated June 09, 2009

Part B - Updated December 09, 2008
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N

Nebraska

Part A - Updated February 01, 2010

Part B - Updated February 01, 2010

Nevada

Part A - Updated February 26, 2009

Part B - Updated February 26, 2009

New Hampshire

Part A - Updated June 05, 2009

Part B - Updated June 01, 2009

NewJersey

MAC - Updated January 14, 2010

New Mexico

MAC - Updated December 31, 2009

New York

Part A - Updated August 01, 2009

Part B - Updated August 01, 2009

North Carolina

Part A - Updated January 01, 2006

Part B - Updated October 01, 2009

North Dakota

Part A - Updated June 09, 2009

Part B - Updated December 09, 2008
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O

Ohio

Part A - Updated August 01, 2009

Part B - Updated February 01, 2010

Oklahoma

MAC - Updated December 31, 2009

Oregon

Part A - Updated June 09, 2009

Part B - Updated February 26, 2009
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P

Pennsylvania

MAC - Updated January 14, 2010
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R

Rhode Island

Part A - Updated June 01, 2009

Part B - Updated May 01, 2009
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S

South Carolina

Part A - Updated October 10, 2003

Part B - Updated November 01, 2009

South Dakota

Part A - Updated June 09, 2009

Part B - Updated December 09, 2008
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T

Tennessee

Part A - Updated August 03, 2009

Part B - Updated February 01, 2010

Texas

MAC - Updated December 31, 2009
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U

Utah

Part A - Updated June 09, 2009

Part B - Updated December 09, 2008
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V

Vermont

Part A - Updated June 05, 2009

Part B - Updated June 01, 2009

Virginia

Part A - Updated August 01, 2009

Part B - Updated December 31, 2009
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W

Washington

Part A - Updated June 09, 2009

Part B - Updated February 26, 2009

West Virginia

Part A - Updated August 01, 2009

Part B - Updated February 01, 2010

Wisconsin

Part A - Updated August 01, 2009

Part B - Updated February 01, 2010

Wyoming

Part A - Updated June 09, 2009

Part B - Updated October 10, 2008
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Indications:
  • DOXIL® (doxorubicin HCl liposome injection) is indicated for the treatment of patients with ovarian cancer whose disease has progressed or recurred after prior platinum-based therapy  
     
  • DOXIL in combination with VELCADE® (bortezomib) is indicated for the treatment of patients with multiple myeloma who have not previously received VELCADE and have received at least one prior therapy  
     
  • DOXIL is indicated for the treatment of AIDS-related Kaposi's sarcoma in patients after failure of prior systemic chemotherapy or intolerance to such therapy  
     
IMPORTANT SAFETY INFORMATION

BOXED WARNINGS:
Cardiotoxicity, infusion reaction, myelosuppression, liver impairment, substitution
  • The use of DOXIL may lead to cardiac toxicity. Myocardial damage may lead to congestive heart failure and may occur as the total cumulative dose of doxorubicin HCl approaches 550mg/m2  
     
    • Prior use of other anthracyclines or anthracenediones should be included in calculations of total cumulative dose
    • Cardiac toxicity may also occur at lower cumulative doses (400 mg/m2) in patients with prior mediastinal irradiation or who are receiving concurrent cyclophosphamide therapy  
       
  • Acute infusion-related reactions including, but not limited to, flushing, shortness of breath, facial swelling, headache, chills, back pain, tightness in the chest or throat, and/or hypotension have occurred in up to 10% of patients treated with DOXIL. In most patients, these reactions have resolved within several hours to a day once the infusion is terminated. In some patients, reactions resolved with slowing of the infusion rate  
     
    • Serious and sometimes life-threatening or fatal allergic/anaphylactoid-like infusion reactions have occurred. Medications to treat such reactions, as well as emergency equipment, should be available for immediate use
    • The initial rate of infusion should be 1mg/min to minimize the risk of infusion reactions  
       
  • Severe myelosuppression may occur  
     
  • DOXIL dosage should be reduced in patients with impaired hepatic function  
     
  • Accidental substitution has resulted in severe side effects. Do not substitute for doxorubicin HCl on a mg per mg basis.
Contraindications
  • Patients with a history of hypersensitivity reactions to a conventional doxorubicin formulation or the components of DOXIL  
     
  • Nursing mothers
Additional Safety Information
  • Cardiac function should be carefully monitored  
     
    • Congestive heart failure or cardiomyopathy may occur after discontinuation of anthracycline therapy
    • For patients with a history of cardiovascular disease, or if the results of cardiac monitoring indicate possible cardiac injury, the benefit of therapy must be weighed against the risk of myocardial injury
    • In the randomized multiple myeloma study, 25 patients (8%) in the VELCADE for Injection arm and 42 patients (13%) in the VELCADE plus DOXIL arm experienced left ventricular ejection fraction decrease (defined as absolute decrease > 15% over baseline or a > 5% decrease below institutional lower limit of normal)
       
  • Myelosuppression may occur; frequently monitor complete blood count (including platelet count), at least prior to each dose of DOXIL  
     
    • In patients with recurrent ovarian cancer or AIDS-related Kaposi's sarcoma, hematologic toxicity (based on platelet count or absolute neutrophil count) may require dose reduction or delay in administration of DOXIL
    • In patients with multiple myeloma, hematologic toxicity (based on platelet count, absolute neutrophil count, hemoglobin level, or neutropenia with fever) may require dose reduction, delay in administration, or suspension of DOXIL and/or VELCADE
    • Persistent severe myelosuppression may result in superinfection, neutropenic fever, or hemorrhage
    • Sepsis occurring during neutropenia has resulted in discontinuation of treatment and in rare cases of death  
       
  • DOXIL may potentiate the toxicity of other anticancer therapies, especially hematologic toxicities, when used in combination with other therapies that suppress bone marrow  
     
  • Hand-foot syndrome (HFS) may occur during therapy with DOXIL  
     
    • Based on HFS toxicity grade, dose reduction, delay in administration, or discontinuation of DOXIL may be required
    • HFS was generally observed after 2 to 3 cycles of treatment, but may occur earlier  
       
      • The reaction was mild in most patients, resolving in 1 to 2 weeks
      • The reaction can be severe and debilitating in some patients, resulting in discontinuation of therapy  
         
  • DOXIL is an irritant, not a vesicant; use precautions to avoid extravasation  
     
  • DOXIL can cause fetal harm when used during pregnancy  
     
  • Recall reaction has occurred with DOXIL administration after radiotherapy  
     
  • DOXIL may interact with drugs known to interact with the conventional formulation of doxorubicin HCl  
     
  • In patients with recurrent ovarian cancer, the most common all-grade adverse reactions (ARs) > 20% (DOXIL vs topotecan, respectively) included: asthenia (40% vs 51%), fever (21% vs 31%), nausea (46% vs 63%), stomatitis (41% vs 15%), vomiting (33% vs 44%), diarrhea (21% vs 35%), anorexia (20% vs 22%), dyspnea (15% vs 23%), HFS (51% vs 1%), and rash (29% vs 12%)  
     
    • In addition, 19% vs 52.3% reported alopecia (all grades).
    • Grade 3/4 hematologic ARs reported in > 5% (DOXIL vs topotecan, respectively) were neutropenia (12% vs 76%) and anemia (6% vs 29%)  
       
  • In patients with multiple myeloma, the most common all-grade ARs > 20% (VELCADE plus DOXIL vs VELCADE, respectively) included: neutropenia (36% vs 22%), thrombocytopenia (33% vs 28%), anemia (25% vs 21%), fatigue (36% vs 28%), pyrexia (31% vs 22%), asthenia (22% vs 18%), nausea (48% vs 40%), diarrhea (46% vs 39%), vomiting (32% vs 22%), constipation (31% vs 31%), mucositis/stomatitis (20% vs 5%), peripheral neuropathy (42% vs 45%), neuralgia (17% vs 20%), and rash (22% vs 18%)  
     
    • In addition, 19% vs < 1% reported HFS  
       
  • In patients with AIDS-related Kaposi's sarcoma, ARs reported in > 5% of DOXIL-treated patients were: neutropenia (ANC < 1000/mm3, 46%; < 500/mm3, 11%), anemia (Hb < 10 g/dL, 58%; < 8 g/dL, 16%), thrombocytopenia (< 150,000 platelets/mm3, 61%), nausea (18%), asthenia (7%), fever (8%), alopecia (9%), vomiting (8%), diarrhea (5%), and stomatitis (5%)  
     
Please click here for DOXIL full Prescribing Information, including Boxed WARNINGS  
 




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