Granisetron hydrochloride (procedure code 1-J1626) is a benefit of the CSHCN Services Program and is limited to the treatment for the following encounter of radiotherapy and chemotherapy diagnosis codes:
Diagnosis Code
Description
V580
Radiotherapy encounter
V5811
Encounter for antineoplastic chemotherapy
V5812
Encounter for immunotherapy for neoplastic condition
The quantity used must appear on the claim.
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
