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Wiki Billing J9201 Gemcitabine and Admin Code 51720 to Medicare

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shalvarson

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I’m reaching out to see if there is any additional help or resources regarding the Gemcitabine J9201 and billing to Medicare for bladder cancer. We are currently using this drug and billing with the administration code 51720 since it’s done through a catheter. However, Medicare is denying all our administration codes 51720 stating that we need to use a 96409 or 96411 code which are for intravenous push. We’ve tried to explain to the Medicare representative and a supervisor that those two codes do not apply since we do not install it intravenous it’s installed through a catheter and we have seemed to hit a wall.
 
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