Wiki Lidolog kit

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slenert

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Has anyone billed for the Lidolog kit J3490 ndc 76420-760-01...the only insurance paying is Tricare and im receiving rejections from IBC, does anyone have any suggestions....
 
I don't have any suggestions, but I've been wondering about these kits. Salesmen are trying to get our docs to order and use them. I'd be interested in how others are billing them and if they're getting paid.

I don't really understand why an insurance company would pay for the kit, in the case of the Lidolog kit the only billable is the Kenalog. Insurance companies don't pay for the lidocaine, gloves, gauze, band-Aid or iodine wipes and you're instructed to bill with an unclassified drug code (J3490), but, the Kenalog has a J code (J3301). So what is the rationale for billing these as unclassified drugs?
 
My office is wondering the same thing we purchased 10 kits just for a trial but have also ran into issues with insurance reimbursement. As of today the only insurance paying for these kits is Tricare at a rate of $288.00 per kit..
 
We are also being approached to buy these kits. They are telling us that they are being reimbursed, using the J3490, by all the major commercial insurance companies. They are stating J3490 is billable because the kit has it's own NDC number?

Would love to hear others comments on this rationale. Thank you.

Kelley Hettig, CPC
Billing and Coding Auditor
Advanced Pain Management
Greenfield, WI 53221
kelley.hettig@apmhealth.com
 
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