Fiscal Intermediary Shared System (FISS) Changes to Automate the Application of Condition Code ZC for Chimeric Antigen Receptor (CAR) T-Cell and Other Immunotherapy Cases Involving a Clinical Trial of a Different Product
The purpose of this Change Request (CR) is to automate the application of payer-only condition code ZC to the claim for CAR-T cell and other immunotherapy cases mapping to Medicare Severity Diagnosis Related Group (MS-DRG) 018, where the product was purchased in the usual manner, but the case involves the clinical trial of a different product.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 10, 2025
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