# albuterol



## jillzeinstra (Feb 24, 2009)

We are having trouble getting albuterol paid, we use J7613 and it is being rejected by Medicare and BCBS, we have tried w/ a KD modifier and Medicare rejected that also.
Any ideas, or suggestions? 
thanks


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## kmhall (Feb 24, 2009)

*Albuterol*

J7613 was deleted in 2008 and re-instated in 2009 but not covered by Medicare.  There were 2 Q codes covered by Medicare in 2008 but they were deleted for 2009.  It appears from the information I was able to obtain that Albuterol is no longer covered by Medicare.  Maybe someone else has further information.  Hope this helps.


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## Lisa Bledsoe (Feb 24, 2009)

J7611, J7612, J7613 and J7614 were all re-activated for 2009.  They are on the Medicare fee schedule.  It could be the diagnosis code(s) you are using.  What is the specific denial reason?


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## amjordan (Feb 24, 2009)

You might check and see if it is covered under the patients Medicare Part D benefit.  If it is, that could be your problem.


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## jillmtom (Feb 26, 2009)

Hello:

We have to bill our J7613 & J7614 to our DMERC carrier with a KO modifier.  Also they require a payable diagnosis.  Our DMERC Carrier is Region B Administar.

Jill Tom, CPC, CCP-P, PCS


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