New ICD-9-CM database provides FDA-approved and off-label uses for therapeutic drugs

RJ Health SystemsFeb 5 2010

A recently released Drug Diagnosis Coding database from RJ Health Systems provides accurate FDA-approved and Compendia-listed off-label uses for therapeutic classes such as Oncology, Anti-Emetics, Erythropoietin Stimulating Agents and Multiple Sclerosis Agents. The new ICD-9-CM database helps ensure more accurate claims submissions and faster claims processing, while eliminating payment for inappropriate off-label uses.

The Compendia listing includes all indications where studies demonstrate beneficial use of the drug in at least some cases. Subscribers to the database also have access to the appropriate reimbursable ICD-9-CMs to the fifth digit, if applicable, for each HCPCS drug code.

Search capabilities include:

• ICD-9-CM
• HCPCS drug code
• Drug name (brand or generic)
• NDC

The database references the Compendia, which are recognized by the Centers for Medicare and Medicaid Services (CMS) for use in the determination of drugs and biologicals used off-label in an anti-cancer chemotherapeutic regimen.

Future releases in 2010 will include Rheumatoid Arthritis Agents, Immunosuppressive Agents, Visco-Supplements, Antiviral Agents (HIV/HepC) and Neuromuscular Agents.

Monthly updates to the database will include new FDA approvals and Compendia listings. The ICD-9-CM database will be expanded to include ICD-10-CMs before the October 2013 implementation.