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Billing for Khapzory Levoleucovorin Injection

Published on 

Tuesday, October 1, 2019

 | RAC Information 
 | FAQ 

Q:

What HCPCS code do we report for the drug Khapzory?



A:

For dates of service on or after October 1, 2019, use HCPCS code J0642 for levoleucovorin injection products marketed under the brand name of Khapzory.

According to the KHAPZORYTM website, it is a folate analog indicated for:

  • Rescue after high-dose methotrexate therapy in patients with osteosarcoma.
  • Diminishing the toxicity associated with overdosage of folic acid antagonists or impaired methotrexate elimination.
  • Treatment of patients with metastatic colorectal cancer in combination with fluorouracil.

Khapzory is the first levoleucovorin product approved by the FDA that contains sodium in its formulation.

Levoleucovorin is also available as the brand name Fusilev (levoleucovorin, calcium) and its generic equivalent (levoleucovorin). These drugs are reported with HCPCS code J0641 effective October 1, 2019. This replaces HCPCS code C9043 as noted in the October OPPS Update. On Monday, September 30, 2019, CMS released a Special Edition of MLN Connects instructing the use of J0642 for the brand Khapzory.

Khapzory and Fusilev are not approved for the treatment of pernicious anemia or megaloblastic anemias.

Providers may want to check payers’ policies concerning the use of these drugs as some payers limit the use of levoleucovorin to when there are shortages of leucovorin, which there currently is. You can check for drug shortages on the FDA website. Also, some payers require providers to use the least costly levoleucovorin product.

Article Author: Debbie Rubio, BS MT (ASCP)
Debbie Rubio, BS MT (ASCP), was the Manager of Regulatory Affairs and Compliance at Medical Management Plus, Inc. Debbie has over twenty-seven years of experience in healthcare including nine years as the Clinical Compliance Coordinator at a large multi-facility health system. In her current position, Debbie monitors, interprets and communicates current and upcoming regulatory and compliance issues as they relate to specific entities concerning Medicare and other payers.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.