ualcpc
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Looking for answers regarding the billing of Mitomycin C injections to Advantra, and getting paid. We are currently having issues getting paid , due to it being a compound drug. They don't like the NDC number. We do have the correct NDC#, as the nurse brought back the packaging. I'm looking to see if any other Urology specialist have had this issue, and did you get it paid? We use HCPC's code J9280 and bill 8 units, 96402. Let me know and thanks in advance!
Sorry, that's 51720 for instillation, not 96402.
Answer: Advantra stated we did have the correct NDC#, they had to manually review the claim as their scrubber system automatically kicks it out. They stated if we would submit Mitomycin C again and it denies, we're to call them and have them review the claim manually. I hope this helps anyone, who may also be having an issue. Lucky for us, they're resending my dos for review and stated a 30 day turn around for processing.
Sorry, that's 51720 for instillation, not 96402.
Answer: Advantra stated we did have the correct NDC#, they had to manually review the claim as their scrubber system automatically kicks it out. They stated if we would submit Mitomycin C again and it denies, we're to call them and have them review the claim manually. I hope this helps anyone, who may also be having an issue. Lucky for us, they're resending my dos for review and stated a 30 day turn around for processing.
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