Question Billing Medicare for Iron infusion

vshubert

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Loudon, TN
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I am trying to submit a claim to Medicare for patient that came to the office and had Iron infusion. The claim CPT codes are 99213 w/25 modifier, 96374, and J1756. The diagnosis code I used is D50.9 and N18.2. Medicare denied J1756 stating it was due to NCD 110.10 Please help!

Thank you in advance.
 

vshubert

Contributor
Messages
12
Location
Loudon, TN
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I reviewed it and from what I understand I have to use 1 approved anemia code and 1 approved CKD code. However the lowest stage it will pay for is CKD stage 3. But there are times where I have patients that are not CKD pts or they are CKD stage 1 or 2. I am trying to find how to correctly charge for those patients.
 
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