Wiki Billing medicare for pump refill medications

Create Wiki
F

fvella

Guest
Messages
4
Best answers
0
:(We are getting denials from Medicare for reimbursement of pump refill medications. What is the correct way to code for BUPIV SO4 Morphine Sulfate
2.5/25mg? I would really appreciate help with this. Also some of our patient's receive just Morphine. I am new to Pain Management Coding and need help with this. We have even appealed one of the claims including all the documentation, but they still denied it. I have been using the J3490 code and writing in the prescription to go with the claim.
 
fvella said:
:(We are getting denials from Medicare for reimbursement of pump refill medications. What is the correct way to code for BUPIV SO4 Morphine Sulfate
2.5/25mg? I would really appreciate help with this. Also some of our patient's receive just Morphine. I am new to Pain Management Coding and need help with this. We have even appealed one of the claims including all the documentation, but they still denied it. I have been using the J3490 code and writing in the prescription to go with the claim.
Click to expand...

Who is your Medicare carrier? I have the guidelines from WPS and Noridian on how they want the compounded pump refills billed to them - so if one of those is your carrier, I can send you the information. Both of them published the information in their newsletters, so if they're not yours, you could search your carrier's newsletters for the information.
 
Thank you so much. I went to the website and printed out the information. I think what I have been missing is the KD modifier and telling them the the Documentation is Available on Request. I wonder if it would be less time consuming to just print the claim to paper and send it manually along with the documentation? Thanks again.
Fae
 
Thank you for the reply. Our carrier is Pa Blue Shield of Western Pennsylvania. I did look up the information from WPS from CustomCoder.net and will try using the KD modifier and including the "route of administration". The other information I was already providing and I was using the J3490 code.
 
Pain pump meds to medicare

We are billing our combination meds with J3490KD, and they are denying electronically by Medicare, so i get a payer report back stating they need a more specific procedure code. How can i fix this so we can get paid?
HELP PLEASE.
 
You must log in or register to reply here.
Top