Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs

GnRH/LHRH analogs (leuprolide, goserelin, triptorelin, histrelin, and leuprolide mesylate) are covered for FDA‑approved indications and recognized off‑label uses that meet LCD L33394, provided administration frequency matches product labeling. Once‑yearly 12‑month implants are generally limited to one payment per 12 months and are covered for prostate cancer only when the physician documents an expectation of survival greater than 12 months; self‑administered formulations (e.g., J9218) are excluded from Medicare Part A/B.

"GnRH/LHRH analogs (leuprolide, goserelin, triptorelin, histrelin, leuprolide mesylate/Camcevi) are covered for FDA‑approved indications and for recognized off‑label uses that meet the criteria of L..."

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