• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Aranesp J0881

Create Wiki
J

JBJ

Contributor
Messages
17
Location
Quincy, IL
Best answers
0
My facility is having the worst time getting these injections paid by Medicare. I have followed the LCD for WPS using J0881 with 585._ and 285.21 for the diagnoses. I add EC modifier as instructed by WPS. I have the HCT and weight charted. What am I missing?
 
JBJ said:
My facility is having the worst time getting these injections paid by Medicare. I have followed the LCD for WPS using J0881 with 585._ and 285.21 for the diagnoses. I add EC modifier as instructed by WPS. I have the HCT and weight charted. What am I missing?
Click to expand...


I worked in Hematology and Oncology so I know how hard it is to get that drug paid. It is not your fault. It's Medicare! I had to do appeals on every patient who was getting it. That could be 40 patients a month. They did start to pay them but only after I did the appeal and it took them a month to come back and pay it. I don't know what to tell you to get it paid. Let me know if you find out.
 
Is your facility documenting a decrease in Aranesp dosage when the Hgb/Hct exceeds the levels specified in the local coverage determination? As the counts improve, the Medicare contractors want to see that the dosage is titrated downward.
 
You must log in or register to reply here.
Top