Anyone else having issues not getting paid from the J3490 code??
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Wiki Anyone else having issues not getting paid from the J3490 code??
- Thread starter pyerneni9@gmail.com
- Start date
ahrx13
Networker
Yes, we've had issues with insurances not reimbursing us for the unlisted code. Are you including the description of the drug in the Additional Information/Box 19 section of the claim? Adding that to our claims helped a lot with getting paid correctly.
For any unlisted code, you should expect to submit some additional information on your claim (as recommended by @ahrx13). You should not be surprised if even with that description, the carrier requests additional information. The payor needs to know what was provided (and sometimes your cost) in order to determine if and how much to pay.
I do believe that I have that additional information entered on the claims but im gonna double check on these. I never had problems in the past many years but all of a sudden bam bam bam denials from all carriers! Thank you!!!