Effective January 28, 2008, the FDA approved Emend® for Injection (fosaprepitant Dimeglumine) for the treatment of chemotherapy-induced nausea (CINV). Palmetto GBA will reimburse IV Emend ONLY according to the FDA approved package insert.
According to the package insert, Emend® for Injection should be infused over a period of fifteen minutes, thirty minutes prior to chemotherapy. The FDA approved indications, when used in combination with other antiemetic agents, include the following:
- Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy including high-dose cisplatin
- Prevention of nausea and vomiting associated with the initial and repeat courses of moderately emotogenic cancer chemotherapy
Palmetto GBA will NOT consider off-label IV Emend requests. Providers who submit claims for off-label IV Emend indications may be targeted for review, Progressive Corrective Action, and Recovery Audit Contractor (RAC) referral.
To receive reimbursement for oral and IV Emend, you must submit the following items on the same claim:
- HCPCS code J3490 – Unclassified drug
- Enter the following information in box 19/narrative field
- NDC#
- Drug name - “IV Emend”
- Dose
- Anti-neoplastic agent
NOTE: The anti-neoplastic agent and Emend IV must be submitted on the same claim.