Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)

This billing/coding guideline clarifies documentation required when billing octreotide (Sandostatin LAR) for chemotherapy-induced diarrhea or VIPoma. For CID-related ICD-10 codes, the record must identify the causative chemotherapy agent(s) and prior antidiarrheal therapy failures; for VIPoma diagnosis or suspicion codes, the record must document a confirmed diagnosis or abnormal clinical/laboratory findings or an abnormal octreotide scan supporting suspicion.

"Octreotide is covered for chemotherapy-induced diarrhea (CID) when claim includes ICD-10-CM codes T38."

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