Update to Local Coverage Determination for Amifostine (Ethyol®)

• Alabama – L5710
• Georgia – L6858
• Mississippi – L20898

Notification of the final Local Coverage Determination for Amifostine (Ethyol®) was published in the March 2006 issue of the Medicare newsletter. The LCD lists ICD-9 codes that support medical necessity. Effective immediately, the following revision is being made under the subtitle “Primary Diagnosis Codes” for ICD-9 code V58.11:

“Use this ICD-9 code when Amifostine is used to reduce the toxicity of cisplatin” is being changed to:

“Use this ICD-9 code when Amifostine is used to reduce the toxicity of platinum-based chemotherapy”.

A copy of the updated Local Coverage Determination can be found at https://www.cahabagba.com. Click on your state for the information you need.