elklein89
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Are there any recommendations for resources on self teaching infusion billing and reimbursement?
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Wiki Infusion billing
- Thread starter elklein89
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ahasson
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The Medicare database might be a good place to start, it's true that it can be overwhelming to start learning. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53778 And I found this article from an infusion EHR similarly helpful. https://weinfuse.com/infusion-billing-confusion/
I bill and code infusions for an ambulatory infusion suite, if you have any specific questions we can exchange emails, in case there is anything I can help with further!
I bill and code infusions for an ambulatory infusion suite, if you have any specific questions we can exchange emails, in case there is anything I can help with further!
Good afternoon ! My practice is having issues with getting the J1602- JW paid. This is not any one particular insurance. The denial reason:
CO-16 Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
M123 Missing/incomplete/invalid name, strength, or dosage of the drug furnished.
MA130 Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct information.
N822 Missing HCPCS modifier(s).
Could someone please assist with this ? Thank you in advance !
CO-16 Claim/service lacks information or has submission/billing error(s). Usage: Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
M123 Missing/incomplete/invalid name, strength, or dosage of the drug furnished.
MA130 Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct information.
N822 Missing HCPCS modifier(s).
Could someone please assist with this ? Thank you in advance !
trarut
True Blue
Are you wanting general or specialty-specific? I've found Revenue Cycle Coding Strategies to be useful with infusion resources but their focus is E&M, Oncology and Radiology services. They have books and online courses. Is there a state society or national organization for the specialty you're dealing with? They likely have resources on their websites to direct you to.
trarut
True Blue
Do you have another line of J1602 on the claim without a modifier to report the given dose? The J1602-JW is telling the plan you're reporting waste, which they won't pay if you're not also reporting the given amount.
Was the JW modifier attached in error? Should it be a JZ modifier for no reportable waste?
If only the drug waste charge line is denied, is the correct NDC number attached and is the record complete? The M123 would have me checking the NDC data being submitted on claim but also has me thinking there's correlating charge line for the quantity of drug the patient received.