I realize this issue has been addressed many times before, but I would like some help.
I realize If a patient is receiving iron for iron def and aranesp, the aranesp will not be covered by medicare for any reason. However we are getting repeat denials on a patient who according to her notes is receiving aranesp for MDS and in listed in the active problems is iron def. improved. Am I correct in assuming the claim is being denied due to the iron def, even though it is improved? I once thought it would not be covered if given the same day as iron, but that does not seem to be the case.
The patient states she will refuse to have the treatment if medicare won't pay. Would hate to see a patient trade her health due to financial concerns
Any guidance would be greatly appreciated.
I realize If a patient is receiving iron for iron def and aranesp, the aranesp will not be covered by medicare for any reason. However we are getting repeat denials on a patient who according to her notes is receiving aranesp for MDS and in listed in the active problems is iron def. improved. Am I correct in assuming the claim is being denied due to the iron def, even though it is improved? I once thought it would not be covered if given the same day as iron, but that does not seem to be the case.
The patient states she will refuse to have the treatment if medicare won't pay. Would hate to see a patient trade her health due to financial concerns
Any guidance would be greatly appreciated.