Wiki Outpatient IUD insert

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colebk

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Hi everyone. I tried looking through the archives, but couldn't find much. My provider performed 58662, 58300, with the device J7298 but the device is being denied as not compatible with POS. The doc took the Mirena from our office stock. What do other offices do - order through specialty pharmacy? Thanks for any assistance or guidance here.
 
colebk said:
Hi everyone. I tried looking through the archives, but couldn't find much. My provider performed 58662, 58300, with the device J7298 but the device is being denied as not compatible with POS. The doc took the Mirena from our office stock. What do other offices do - order through specialty pharmacy? Thanks for any assistance or guidance here.
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It would be correct for them to deny it for POS because the facility bills for all supplies, not the physician. You can of course appeal the denial and will probably then be reimbursed. As to coding, it would not be accurate to bill the J code with an office POS as it was not used in that setting, and I am not sure there is a sure-fire work around for this. You could try using the office POS for the supply and see what happens. Is there some reason the provider did not let the facility supply the device?
 
nielynco said:
It would be correct for them to deny it for POS because the facility bills for all supplies, not the physician. You can of course appeal the denial and will probably then be reimbursed. As to coding, it would not be accurate to bill the J code with an office POS as it was not used in that setting, and I am not sure there is a sure-fire work around for this. You could try using the office POS for the supply and see what happens. Is there some reason the provider did not let the facility supply the device?
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Okay, that's what logic and reason were telling me. Our coder/biller was let go and we're working denials. I don't typically deal with the facility side. Your explanation makes perfect sense. Thank you!!
 
At our office, IF the provider takes it from our stock - we cannot bill for it - it would be our loss their gain. We have now had the hospital pharmacy in charge of making sure that there is an IUD in stock at the hospital for the patient so that the hospital can bill for that as well.
 
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