Wiki Actemra

[kboyd22]

Is anyone having problems with Medicare denying J3262 as a duplicate. We have 3 different vials that each have their own NDC # so when a patient receives 600 mg(1-200 mg vial and 1-400 mg vial) we bill on two lines: j3262 x 200 (w/respective NDC) and J3262 x 400(w/respective NDC) but in December Medicare started denying on of the lines as a duplicate.

Thank you for any insight.

 

[keagaddis@hotmail.com]

I know this is an old post but we are currently experiencing this exact same problem. Should it all be billed on one line and if so which NDC number is used if all 3 vials strengths are used?

Thank you in advance for your help with this

 

[SharonCollachi]

I'm not sure about Medicare, but United Healthcare has a policy that you bill modifier KP for the first drug and modifier KQ for all subsequent drugs.