Supporting Access to Treatment

Helping patients gain access to treatment

Mallinckrodt is committed to helping patients with CTCL skin manifestations have access to treatment.

For patients who do not have public or private prescription coverage, Mallinckrodt is currently exploring sponsorship opportunities to help offer some support to qualifying patients who cannot afford the photopheresis therapy prescribed to them.

Program details will be made available in 2022 as soon as they are available.

Reimbursement Reference Guide

Billing and coding support for informational purposes only

The following, including all CPT* and HCPCS codes, is provided for informational purposes only, is not intended to serve as reimbursement or legal advice, and represents no statement, promise, or guarantee by Mallinckrodt that the codes are appropriate, or concerning levels of reimbursement, payment, or charge. This information is not intended to increase or maximize reimbursement by any payer. Reimbursement information is subject to change at any time and any such changes may not be reflected on this website. You should check with your specific payers to ensure that you have the most up-to-date information applicable to them, including their reimbursement policies.

It is each provider’s responsibility to determine whether the services are accurately described by any specific code(s) and to report those services consistent with specific payer requirements. In all cases, services billed must be medically necessary, actually performed as reported, and appropriately documented. You are ultimately responsible for determining the appropriate reimbursement processes and billing codes.

*CPT copyright 2022 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA)

Diagnosis and billing codes

Procedure Code Descriptor Code Type of Code
Extracorporeal photopheresis 36522 CPT-4 procedure code
Phototherapy, Circulatory, Single 6A650ZZ ICD-10 procedure code
Phototherapy, Circulatory, Multiple 6A651ZZ ICD-10 procedure code

You are ultimately responsible for determining the appropriate reimbursement strategies and billing codes.

  ICD-10 Code Fifth-Digit Subclassifications
Mycosis Fungoides C84.0
  • Unspecified site

  • Lymph nodes of head, face, and neck

  • Intrathoracic lymph nodes

  • Intra-abdominal lymph nodes

  • Lymph nodes of axilla upper limb

  • Lymph nodes of inguinal region and lower limb

  • Intrapelvic lymph nodes

  • Spleen

  • Lymph nodes of multiple sites

  • Extranodal and solid organ sites

Sézary Syndrome C84.1
 

Example: C84.18 represents Sézary syndrome with lymph node involvement in multiple sites.

 

THERAKOS Photopheresis is covered by most public and private insurers

For additional information, download the Reimbursement Reference Guide.

INDICATIONS AND USAGE

UVADEX® (methoxsalen) Sterile Solution is indicated for extracorporeal administration with the THERAKOS® CELLEX® Photopheresis System in the palliative treatment of the skin manifestations of Cutaneous T-Cell Lymphoma (CTCL) that is unresponsive to other forms of treatment.

IMPORTANT SAFETY INFORMATION

CAUTION: READ THE THERAKOS CELLEX PHOTOPHERESIS SYSTEM’S OPERATOR’S MANUAL PRIOR TO PRESCRIBING OR DISPENSING THIS MEDICATION.
UVADEX (methoxsalen) Sterile Solution should be used only by physicians who have special competence in the diagnosis and treatment of cutaneous T-cell lymphoma and who have special training and experience in the THERAKOS CELLEX Photopheresis System. Please consult the CELLEX Operator's Manual before using this product.

CONTRAINDICATIONS

UVADEX is contraindicated in:

  • Patients exhibiting idiosyncratic or hypersensitivity reactions to methoxsalen, other psoralen compounds, or any of the excipients

  • Patients possessing a specific history of a light-sensitive disease state, including lupus erythematosus, porphyria cutanea tarda, erythropoietic protoporphyria, variegate porphyria, xeroderma pigmentosum, and albinism

  • Patients with aphakia because of significantly increased risk of retinal damage

  • Patients that have contraindications to the photopheresis procedure

WARNINGS AND PRECAUTIONS

  • Patients who are receiving concomitant therapy (either topically or systemically) with known photosensitizing agents such as anthralin, coal tar or coal tar derivatives, griseofulvin, phenothiazines, nalidixic acid, halogenated salicylanilides (bacteriostatic soaps), sulfonamides, tetracyclines, thiazides, and certain organic staining dyes such as methylene blue, toluidine blue, rose bengal, and methyl orange may be at greater risk for photosensitivity reactions with UVADEX

  • Oral administration of methoxsalen followed by cutaneous UVA exposure (PUVA therapy) is carcinogenic. Methoxsalen also causes DNA damage, interstrand cross-links and errors in DNA repair

  • Methoxsalen may cause fetal harm when given to a pregnant woman. Women of childbearing potential should be advised to avoid becoming pregnant.  If UVADEX is used during pregnancy, or if the patient becomes pregnant while receiving UVADEX, the patient should be apprised of the potential hazard to the fetus 

  • Severe photosensitivity can occur in patients treated with UVADEX. Advise patients to wear UVA absorbing, wrap-around sunglasses and cover exposed skin or use a sunblock (SPF 15 or higher), and avoid all exposure to sunlight for twenty-four (24) hours following photopheresis treatment

  • After methoxsalen administration, exposure to sunlight and/or ultraviolet radiation may result in "premature aging" of the skin

  • Since oral psoralens may increase the risk of skin cancers, monitor closely those patients who exhibit multiple basal cell carcinomas or who have a history of basal cell carcinomas

  • Serious burns from either UVA or sunlight (even through window glass) can result if the recommended dosage of methoxsalen is exceeded or precautions are not followed

  • Exposure to large doses of UVA light causes cataracts in animals. Oral methoxsalen exacerbates this toxicity

  • Safety in children has not been established

  • Thromboembolic events, such as pulmonary embolism and deep vein thrombosis, have been reported with UVADEX administration through photopheresis systems for treatment of patients with graft-versus-host disease, a disease for which UVADEX is not approved

ADVERSE REACTIONS

  • Side effects of photopheresis (UVADEX used with the THERAKOS Photopheresis Systems) were primarily related to hypotension secondary to changes in extracorporeal volume (>1%)

For the THERAKOS® CELLEX® Photopheresis Procedure:

INDICATIONS

The THERAKOS CELLEX Photopheresis System is indicated for use in the ultraviolet-A (UVA) irradiation, in the presence of the photoactive drug 8-methoxypsoralen (8-MOP®), of extracorporeally circulating leukocyte-enriched blood, in the palliative treatment of the skin manifestations of cutaneous T-cell lymphoma (CTCL), in persons who have not been responsive to other forms of treatment.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

The THERAKOS CELLEX Photopheresis System is not designated, sold, or intended for use except as indicated.

Certain underlying medical conditions contraindicate THERAKOS Photopheresis, including patients:

  • who cannot tolerate extracorporeal volume loss during the leukocyte-enrichment phase

  • exhibiting idiosyncratic or hypersensitivity reactions to 8-methoxypsoralen/psoralen compounds

  • with coagulation disorders

  • who have had previous splenectomy

WARNINGS AND PRECAUTIONS

  • THERAKOS Photopheresis treatments should always be performed in locations where standard medical emergency equipment is available. Volume replacement fluids and/or volume expanders should be readily available throughout the procedure

  • Patients who may not be able to tolerate the fluid changes associated with extracorporeal photopheresis should be monitored carefully

  • Procedures, such as renal dialysis, which might cause significant fluid changes (and expose the patient to additional anticoagulation) should not be performed on the same day as extracorporeal photopheresis

  • Individual patients may require a heparin dosage that varies from the recommended dose to prevent post-treatment bleeding or clotting during a treatment

ADVERSE REACTIONS

  • Hypotension may occur during any treatment involving extracorporeal circulation. Closely monitor the patient during the entire treatment for hypotension

  • Transient pyretic reactions, 37.7-38.9°C (100-102°F), have been observed in some patients within six to eight hours of reinfusion of the photoactivated leukocyte-enriched blood. A temporary increase in erythroderma may accompany the pyretic reaction

  • Treatment frequency exceeding labeling recommendations may result in anemia

  • Venous access carries a small risk of infection and pain

Please see accompanying Full Prescribing Information, including the BOXED WARNING for UVADEX, and see the THERAKOS Photopheresis System Operator’s Manual.
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