Has anyone used J3490 for Aveed 3cc 750mg/3ml 250 mg/ml? I contacted TN Medicare for reimbursement rate, but the rep was unable to give me an amount. She stated the invoice must be submitted and reimbursement is based from the invoice. We have never used this medicine before, but one of the providers has an interest.
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Wiki J3490 for Aveed
- Thread starter michelleaapc2012
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Kelly_Mayumi
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Unfortunately, I don't know if we've been paid on the claim we used it on, but that's the drug code we used. I haven't seen it back denied?
sneuman
Contributor
We just recently started using this medication in our office. Currently, there is no set fee schedule for any insurance carriers due to it being a new drug. With each claim I bill, I have to submit the clinical documentation as well as the invoice for the drug in order for it to be paid upon. We mostly have this ordered through a speciality pharmacy as we haven't been profiting from the cost and admin and have found that most patients contracts' don't cover this under their medical benefits without a pre-determ/prior auth being done. I'd double check that prior to administration. Better to be safe than sorry and have to do a lot of retro auths.
Good luck!
Good luck!
draughne@gmail.com
Guest
J3490 (Unassigned Drug) Testopel
We have used that code J3490 for Testopel injections and it does pay. I have recieved payments from BCBS, Medicare and other carriers and it pays well, but you have to follow the guidelines on how it is billed to Medicare or your Commerical Carriers. We had many problems at the beginning of the year for all carriers due to it was not billed correctly. Otherwise, I suggest you ask your medical rep on copies of the CMS-1500 forms to show you the correct way to bill it, so you are not delayed in your payments.
We have used that code J3490 for Testopel injections and it does pay. I have recieved payments from BCBS, Medicare and other carriers and it pays well, but you have to follow the guidelines on how it is billed to Medicare or your Commerical Carriers. We had many problems at the beginning of the year for all carriers due to it was not billed correctly. Otherwise, I suggest you ask your medical rep on copies of the CMS-1500 forms to show you the correct way to bill it, so you are not delayed in your payments.
lmahoney@mcw.edu
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If you look on the internet under Aveed coding and billing you will find information. J codes and NDC numbers must be on the claim for the drug along with special instructions for the HCFA form. This is probably a carrier priced code so send in all your records as well to get it reimbursed. I know with new drugs in our area we need to make sure we have the NDC numbers on the claims.