Medications currently available to treat Multiple Myeloma include: Current Code Price (AWP) Effective Date. Code Price (AWP)

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1 drug and administration compendia Compendia information developed and maintained by With each publication Managed Care Oncology s Drug & Compendia will highlight a single medication or a group of medications that could be utilized in the management of one of the featured oncology diseases. This section will address such topics as: Suggested ICD-9-CM coding Possible Medication(s) used to treat the conditions; including ancillary medication(s) Reimbursement and Coding Information (How to Bill for New Medications) or CPT Coding Information Current AWP Based Pricing Most recent ASP Plus 6% (Medicare Allowable) Possible Codes that can be utilized with each medication Associated ICD-9-CM Codes: Multiple myeloma Kahler s disease Myelomatosis Excludes: solitary myeloma (238.6) Medications currently available to treat Multiple Myeloma include: J9041 Bortezomib VELCADE Description Current Code Price (AWP) Effective Date Code Price (AWP) ASP + 6% (Medicare Allowable) Effective dates 04/01/07 6/30/07 bortezomib, 0.1 mg 02/01/07 $40.36 $ , 96411,, J1100 Dexamethasone sodium phosphate DEKASOL dexamethasone sodium phosphate, 1 mg 01/01/03 $0.15 $ , 96411,, J7506 Prednisone DELTASONE, ORASONE J8530 Cyclophosphamide CYTOXAN J8540 Dexamethasone DECADRON J8600 Melphalan ALKERAN J9000 Doxorubicin ADRIAMYCIN Prednisone, oral, 5 mg 04/05/04 $0.05 $0.19 Cyclophosphamide, oral, 25 mg 09/01/06 $2.03 $0.97 Dexamethasone, oral, 0.25 mg 11/29/05 $0.11 $0.25 Melphalan, oral, 2 mg 12/29/04 $4.72 $2.32 Doxorubicin HCl, 08/07/03 $13.75 $ , 96411,, 30 managedcareoncology Spring 2007

2 J9001 Doxorubicin lipsomal DOXIL J9090 Cyclophosphamide CYTOXAN J9091 Cyclophosphamide CYTOXAN J9092 Cyclophosphamide CYTOXAN Description Doxorubicin, all lipid formulations, Current Code Price Effective Date Code Price (AWP) ASP + 6% (Medicare Allowable) Effective Dates 04/01/07 6/30/07 03/01/07 $ $ , 96411,, Cyclophosphamide, 500 mg 09/27/04 $15.80 $ , 96411,, Cyclophosphamide 1.0 gm 09/27/04 $28.45 $ , 96411,, Cyclophosphamide, 2.0 gm 09/27/04 $51.20 $ , 96411,, J9245 Melphalan ALKERAN melphalan, 50 mg 02/01/07 $1, $1, , 96411,, J9370 Vincristine sulfate VINCASAR J9375 Vincristine sulfate VINCASAR J9380 Vincristine sulfate VINCASAR Vincristine sulfate, 1 mg 09/01/05 $10.00 $ , 96411,, Vincristine sulfate, 2 mg 09/01/05 $20.00 $ , 96411,, Vincristine sulfate, 5 mg 09/01/05 $50.00 $ , 96411,, Additional Non-Classified Medications (These medications have not been assigned a Code by CMS) J8499: Prescription drug, oral, non-chemotherapeutic, Not Otherwise Specified** Generic/Strength/ NDC (National Drug Code) AWP/Unit Effective Date AWP Effective Date WAC + 106% (Medicare Allowable) Effective Date Codes Lenalidomide 5 mg REVLIMID , $295.36/tab 1/1/07 $250.47/tab 1/10/07 Lenalidomide REVLIMID , $309.09/tab 1/1/07 $262.12/tab 1/10/07 Lenalidomide 15 mg REVLIMID , $360.50/tab 1/1/07 $305.70/tab 1/10/07 Lenalidomide 25 mg REVLIMID , $379.81/tab 1/1/07 $322.08/tab 1/10/07 Thalidomide 50 mg THALOMID Thalidomide 100 mg THALOMID Thalidomide 150 mg THALOMID , $106.88/tab 3/28/07 $90.64/tab 3/28/ , $173.50/tab 3/28/07 $147.13/tab 3/28/ , $185.51/tab 3/28/07 $157.32/tab 3/28/07 Thalidomide 200 mg THALOMID , $197.53/tab 3/28/07 $167.51/tab 3/28/07 ** When billing with a CMS 1500 claim form, you must include both the code J8499 in Column 24D and the NDC (National Drug Code) in Box 19 in order to ensure appropriate reimbursement. Multiple Myeloma References Level II Expert Current Procedural Terminology (CPT) ICD-9-CM for Physicians Volumes 1 & The Drug Reimbursement Coding and Pricing Guide by R J Health Systems International, LLC Volume 4, Number 2, 2nd Quarter The information contained was supplied by R J Health Systems International, LLC located in Wethersfield, Connecticut. Prices listed herein are effective as of May 1,

3 Oncology Related Codes This reference chart will assist the Oncology Office (Office Manager, Oncology Nurse, Physician and Ancillary Staff) and payor with the appropriate codes to utilize when billing or reimbursing for medication(s). J0180 Agalsidase beta FABRAZYME agalsidase beta, 1 mg Lipidoses- Fabry s disease (272.7) $ /1/2005 $ J0881 Darbepoetin alfa ARANESP darbepoetin alfa, 1 microgram (non-esrd use) Anemia in chronic kidney disease (285.21) Anemia in neoplastic disease (285.22) Anemia in chronic kidney disease (285.21) Anemia, unspecified (285.9) $5.72 2/1/07 $ J0885 Epoetin alfa PROCRIT, EPOGEN epoetin alfa, (for non-esrd use), 1000 units Anemia in chronic kidney disease (285.21) Anemia in neoplastic disease (285.22) Anemia in neoplastic disease (285.22) Anemia, unspecified (285.9) Anemia of other chronic disease (285.29) Essential thrombocythemia (238.71) Low grade myelodysplastic syndrome lesions (238.72) High grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79) $15.01 $ J1440 Filgrastim NEUPOGEN filgrastim (G-CSF), 300 mcg Agranulocytosis (288.0) Other specified disease of white blood cells (288.8) Myeloid leukemia (205._) Monocytic leukemia (206._) Other specified cell type-acute-in remission (208.01) Essential thrombocythemia (238.71) Low grade myelodysplastic syndrome lesions (238.72) High grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79) Neutropenia, unspecified (288.00) Congential neutropenia (288.01) Cyclic neutropenia (288.02) Drug induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53) $ $ J1441 Filgrastim NEUPOGEN filgrastim (G-CSF), 480 mcg Agranulocytosis (288.0) Other specified disease of white blood cells (288.8) Myeloid leukemia (205._) Monocytic leukemia (206._) Other specified cell type-acute-in remission (208.01) Essential thrombocythemia (238.71) Low grade myelodysplastic syndrome lesions (238.72) $ $ managedcareoncology Spring 2007

4 J1441 Filgrastim NEUPOGEN Cont. High grade myelodysplastic syndrome lesions (238.73) Myelodysplastic syndrome with 5q deletion (238.74) Myelodysplastic syndrome, unspecified (238.75) Myelofibrosis with myeloid metaplasia (238.76) Other lymphatic and hematopoietic tissues (238.79) Neutropenia, unspecified (288.00) Congential neutropenia (288.01) Cyclic neutropenia (288.02) Drug induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53) J1626 Granisetron KYTRIL granisetron, 100 mcg Symptoms involving digestive system Nausea with vomiting (787.01) Symptoms involving digestive system Nausea with vomiting (787.01) Symptoms involving digestive system Vomiting alone (787.03) Other and unspecified adverse effect of drug, medicinal and biological substance (995.2) $ /9/2004 $ J1950 Leuprolide acetate LUPRON DEPOT leuprolide acetate (for depot suspension), per 3.75 mg Leiomyoma of uterus, unspecified (218.9) Endometriosis, site unspecified (617.9) Endometriosis (617._) $ $ J2469 Palonosetron ALOXI palonosetron HCl, 25 mcg Symptoms involving digestive system- Nausea with vomiting (787.01) Symptoms involving digestive system- Nausea with vomiting (787.01) Symptoms involving digestive system- Vomiting alone (787.03) Unspecified adverse effect of unspecified drug, medicinal and biological substance (995.20) Arthus phenomenon (995.21) Unspecified adverse effect of anesthesia (995.22) Unspecified adverse effect of insulin (995.23) Other and unspecified adverse effect of drug, medicinal and biological substance- Other drug allergy (995.27) Unspecified adverse effect of other drug, medicinal and biological substance (995.29) $39.84 $16.00 J2505 Pegfilgrastim NEULASTA pegfilgrastim, 6 mg Neutropenia (288.0) Neutropenia, unspecified (288.00) Congential neutropenia (288.01) Cyclic neutropenia (288.02) Drug induced neutropenia (288.03) Neutropenia due to infection (288.04) Other neutropenia (288.09) Hemophagocytic syndromes (288.4) Leukocytopenia, unspecified (288.50) Lymphocytopenia (288.51) Other decreased white blood cell count (288.59) Neutropenic splenomegaly (289.53) $3, $2,

5 J3315 Triptorelin pamoate TRELSTAR DEPOT, TRELSTAR LA triptorelin pamoate, 3.75 mg prostate (185) $ /17/2005 $ J3487 Zoledronic acid ZOMETA zoledronic acid, 1 mg Hypercalcemia (275.42) Multiple myeloma (203.0) Bone and bone marrow (198.5) Hypercalcemia (275.42) Multiple myeloma (203.0_) Bone and bone marrow (198.5) Disorder of bone and cartilage, unspecified (733.90) $ /1/2007 $ J9001 Doxorubicin liposome DOXIL Doxorubicin, all lipid formulations, ovary and other uterine adnexa (183._) Kaposi s sarcoma (176._) male Kaposi's sarcoma (176._) ovary and other Multiple myeloma (203.0_) $ $ J9035 Bevacizumab AVASTIN bevacizumab, colon (153._) rectum, rectosigmoid junction, and anus (154._) male colon (153._) rectum, rectosigmoid junction, and anus (154._) trachea, bronchus, $ /1/2005 $57.53 J9041 Bortezomib VELCADE bortezomib, 0.1 mg Multiple myeloma and immunoproliferative neoplasms-multiple myeloma (203.0_) Other lymphomas-unspecified site, extranodal and solid organ sites (Mantle Cell Lymphoma) (202.80) Multiple myeloma-without mention of remission (203.0_) $40.36 $ J9045 Carboplatin PARAPLATIN Carboplatin, 50 mg ovary and other uterine adnexa (183._) lip (140._) tongue (141._) major salivary glands (142._) gum (143._) floor of mouth (144._) other and unspecified parts of mouth (145._) oropharynx (146._) nasopharynx (147._) hypopharynx (148._) other and ill-defined sites within the lip, oral cavity, and pharynx (149._) nasal cavities, middle ear, and accessory sinuses (160._) larynx (161._) bladder (188._) brain (191._) male Malignant neoplasm without specification of site-disseminated (199.0) Malignant neoplasm without specification of site-other (199.1) cervix uteri (180._) body of uterus- Corpus uteri, except isthmus (182.0) esophagus (150._) ovary and other uterine adnexa-fallopian tube (183.2) $ /3/2006 $ managedcareoncology Spring 2007

6 J9045 Carboplatin PARAPLATIN Cont. other and ill-defined sites-head, face, and neck (195.0) Hodgkin's disease (201. ) trachea, bronchus, Malignant melanoma of skin (172._) nasal cavities, middle ear, and accessory sinuses (160._) other endocrine glands and related structures-adrenal gland (194.0) Lymphosarcoma and reticulosarcoma (200. ) Other malignant neoplasms of lymphoid and histiocytic tissue (202. ) ovary and other Specified parts of peritoneum (158.8) Peritoneum, unspecified (158.9) Secondary malignant neoplasm of respiratory and digestive systems-retroperitoneum and peritoneum (197.6) eye-retina (190.5) testis (186._) kidney and other and unspecified urinary organs-kidney, except pelvis (189.0) J9055 Certuximab ERBITUX cetuximab, colon (153._) rectum, rectosigmoid junction, and anus (154._) colon (153._) rectum, rectosigmoid junction, and anus (154._) lip (140._) tongue (141._) major salivary glands (142._) gum (143._) floor of mouth (144._) other and unspecified parts of mouth (145._) oropharynx (146._) nasopharynx (147._) hypopharynx (148._) other and ill-defined sites within the lip, oral cavity, and pharynx (149._) nasal cavities, middle ear, and accessory sinuses (160._) larynx (161._) other and ill-defined sites-head, face, and neck (195.0) $ /1/2005 $49.81 J9170 Docetaxel TAXOTERE Docetaxel, 20 mg male trachea, bronchus, prostate (185) bladder (188._) male esophagus (150._) lip (140._) tongue (141._) major salivary glands (142._) gum (143._) floor of mouth (144._) other and unspecified parts of mouth (145._) oropharynx (146._) nasopharynx (147._) hypopharynx (148._) $ /1/2007 $

7 J9170 Docetaxel TAXOTERE Cont. other and ill-defined sites within the lip, oral cavity, and pharynx (149._) nasal cavities, middle ear, and accessory sinuses (160._) larynx (161._) other and ill-defined sites-head, face, and neck (195.0) trachea, bronchus, ovary and other stomach (151._) J9201 Gemcitabine GEMZAR Gemcitabine HCl, 200 mg male trachea, bronchus, pancreas (157._) bladder (188._) male gallbladder and extrahepatic bile ducts (156._) ovary and other testis (186._) thymus, heart, and mediastinum-anterior mediastinum (164.2) thymus, heart, and mediastinum-posterior mediastinum (164.3) thymus, heart, and mediastinum-other (164.8) thymus, heart, and mediastinum-mediastinum, part unspecified (164.9) retroperitoneum and peritoneum (158._) placenta (181) other endocrine glands and related structures-pineal gland (194.4) Hodgkin's disease (201. ) Lymphosarcoma and reticulosarcoma (200._) Other malignant neoplasms of lymphoid and histiocytic tissue (202._) ovary and other pancreas (157._) testis (186._) $ $ J9206 Irinotecan CAMPTOSAR Irinotecan, 20 mg colon (153._) rectum, rectosigmoid junction, and anus (154._) cervix uteri (180._) colon (153._) rectum, rectosigmoid junction, and anus (154._) trachea, bronchus, ovary and other uterine adnexa (183._) $ /27/2004 $ J9217 Leuprolide acetate LUPRON DEPOT, ELIGARD Leuprolide acetate (for depot suspension), 7.5 mg prostate (185) Leiomyoma of uterus, unspecified (218.9) Other endocrine disorders- Precocious sexual development and puberty, not elsewhere classified (pediatric injection or depot-ped) (259.1) Endometriosis, site unspecified (617.9) Endometriosis (617._) $ /1/2006 $ managedcareoncology Spring 2007

8 J9218 Leuprolide acetate LUPRON Leuprolide acetate, per 1 mg prostate (185) Endometriosis (617._) $ /1/2006 $ J9263 Oxaliplatin ELOXATIN oxaliplatin, 0.5 mg colon (153._) rectum, rectosigmoid junction, and anus (154._) colon (153._) rectum, rectosigmoid junction, and anus (154._) stomach (151._) $11.19 $8.97 J9264 Paclitaxel protein-bound particles ABRAXANE paclitaxel protein-bound particles,1 mg male male $ /1/2006 $8.66 J9265 Paclitaxel ONXOL, TAXOL Paclitaxel, 30 mg Onxol ovary and other uterine adnexa (183._) male Taxol ovary and other uterine adnexa (183._) male trachea, bronchus, and lung (162._) Kaposi's sarcoma (176._) bladder (188._) male Malignant neoplasm without specification of site-disseminated (199.0) Malignant neoplasm without specification of site-other (199.1) cervix uteri (180._) body of uterus- Corpus uteri, except isthmus (182.0) esophagus (150._) ovary and other uterine adnexa-fallopian tube (183.2) lip (140._) tongue (141._) major salivary glands (142._) gum (143._) floor of mouth (144._) other and unspecified parts of mouth (145._) oropharynx (146._) nasopharynx (147._) hypopharynx (148._) other and ill-defined sites within the lip, oral cavity, and pharynx (149._) nasal cavities, middle ear, and accessory sinuses (160._) larynx (161._) other and ill-defined sites-head, face, and neck (195.0) trachea, bronchus, Kaposi's sarcoma (176._) ovary and other Specified parts of peritoneum (158.8) Peritoneum, unspecified (158.9) stomach (151._) testis (186._) $ $12.59 J9305 Pemetrexed disodium ALIMTA pemetrexed, trachea, bronchus, pleura (163._) trachea, bronchus, pleura (163._) $54.43 $

9 J9310 Rifuximab RITUXAN Rituximab, 100 mg Lymphosarcoma and reticulosarcoma (200. ) Other malignant neoplasms of lymphoid and histiocytic tissue (202. ) Rheumatoid arthritis and other inflammatory polyarthropathies (714._) Lymphoid leukemia-chronic (204.1_) Lymphosarcoma and reticulosarcoma (200. ) Other malignant neoplasms of lymphoid and histiocytic tissue (202. ) Immune thrombocytopenic purpura (287.31) Disorders of plasma protein metabolism- Macroglobulinemia (273.3) $ $ J9355 Trastuzumab HERCEPTIN Trastuzumab, male male $70.64 $57.87 **The Code Price is based on the Code Description. (Healthcare Common Procedure Coding System) codes are a component of CMS (Centers for Medicare and Medicaid Services). The Code Price is an AWP based pricing methodology developed by R J Health Systems International, LLC., Wethersfield, CT Oncology Related J-Code References Level II Expert Current Procedural Terminology (CPT) The Association of Community Cancer Centers Compendia-Based Drug Bulletin February American Medical Association. Physician ICD-9-CM 2007 Volumes 1 and 2. AMA Press, Full prescribing information for each drug listed. The Drug Reimbursement Coding and Pricing Guide by R J Health Systems International LLC Volume 4, Number 2, 2nd Quarter New Compendia Approved Indications Generic/BRAND Drug Name Compendia Approved ICD-9-CM ICD-9-CM Description Comments Paclitaxel, protein bound ABRAXANE 174._ 175._ female breast male breast Metastatic breast cancer, first-line treatment as monotherapy** Arsenic trioxide TRISENOX Neoplasm of uncertain behavior of other and unspecified sites and tissues-essential thrombocythemia Neoplasm of uncertain behavior of other and unspecified sites and tissues-low grade myelodysplastic syndrome lesions Neoplasm of uncertain behavior of other and unspecified sites and tissues-high grade myelodysplastic syndrome lesions Neoplasm of uncertain behavior of other and unspecified sites and tissues-myelodysplastic syndrome with 5q deletion Neoplasm of uncertain behavior of other and unspecified sites and tissues-myelodysplastic syndrome, unspecified Neoplasm of uncertain behavior of other and unspecified sites and tissues-myelofibrosis with myeloid metaplasia Neoplasm of uncertain behavior of other and unspecified sites and tissues-other lymphatic and hematopoietic tissues Monotherapy in transfusiondependent patients Raloxifene EVISTA 174._ female breast Prophylaxis in high-risk, postmenopausal women Irinotecan CAMPTOSAR 183._ ovary and other uterine adnexa Platinum-refractory, platinum-resistant References The Association of Community Cancer Centers Compendia-Based Drug Bulletin February American Medical Association. Physician ICD-9-CM 2007 Volumes 1 and 2. AMA Press, **ABRAXANE Compendia Listing- United States Pharmacopia Drug Index (USPDI). January Special thanks to 41