KEYTRUDA FOR ADVANCED CERVICAL CANCER

The following codes as of September 2023 are provided as a reference and may be relevant when billing for KEYTRUDA and its administration. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of its use and for information on additional codes. Diagnosis codes should be selected only by a health care professional. You are solely responsible for determining the appropriate codes and for any action you take in billing.

When submitting a claim for KEYTRUDA, always verify coding requirements with the relevant payer. Coding requirements may vary by insurer or plan; please refer to the payer-specific policies to understand what may be covered.

Check with the relevant payer regarding guidance on which diagnoses they will recognize and the applicability of secondary codes. Health care professionals are solely responsible for selecting codes that appropriately reflect the patient’s diagnosis, the services rendered, and the applicable payers’ guidelines.

Providers should document the diagnosis with a sufficiently high degree of specificity based on the information available to enable the identification of the most appropriate code. Although CMS has said that an unspecified code may be appropriate in some cases, CMS has advised that you should always code with as much specificity as possible consistent with the clinical documentation.

Merck and its agents make no warranties concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. Merck cautions that payer-coding requirements vary and can frequently change, so it is important to regularly check with each payer or, where applicable, the Medicare Administrative Contractor as to payer-specific requirements. The use of this information does not guarantee payment or that any payment received will cover your costs.

Indication

KEYTRUDA, in combination with chemotherapy, with or without bevacizumab, is indicated for the treatment of patients with persistent, recurrent, or metastatic cervical cancer whose tumors express programmed death ligand 1 (PD-L1) [combined positive score (CPS) ≥1] as determined by an FDA-approved test.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS ≥1) as determined by an FDA-approved test.

FDA-Approved Dosing

The FDA-approved dose of KEYTRUDA is either 200 mg administered after dilution as an intravenous infusion over 30 minutes every 3 weeks or 400 mg administered after dilution as an intravenous infusion over 30 minutes every 6 weeks, until disease progression, unacceptable toxicity, or up to 24 months.

When administering KEYTRUDA in combination with chemotherapy with or without bevacizumab, administer KEYTRUDA prior to chemotherapy with or without bevacizumab when given on the same day. Refer to the Prescribing Information for bevacizumab and for the chemotherapy agents administered in combination with KEYTRUDA for recommended dosing information, as appropriate.

See full Prescribing Information for preparation and administration instructions and dosage modifications for adverse reactions.

Possible relevant diagnosis codes for cervical cancer

Learn more about each diagnosis code and descriptor by selecting from the series options below.

 

C53: Malignant Neoplasm of Cervix Uteri4

The C53 series:

  • Excludes: carcinoma in situ of cervix uteri
ICD-10-CM CODE DESCRIPTOR
C53.0 Malignant neoplasm of endocervix
C53.1 Malignant neoplasm of exocervix
C53.8 Malignant neoplasm of overlapping sites of cervix uteri
C53.9 Malignant neoplasm of cervix uteri, unspecified