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Wiki Billing Radiopharmaceuticals under Medicare

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4
Location
Linden, NJ
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0
We routinely bill nuclear stress tests (78542) along with TC-99m (A9502).

Several months ago, Medicare began denying code A9502 saying they need the paper invoice for the drug on file, which seemed egregious. We called Medicare, who said to include the name of the drug, the dosage, and the invoice amount in the 'additional info' line on the claim.

We've done that and we're still getting denied. What am I doing wrong here? Is it possible that we actually have to send the paper invoice for every stress test that involves this drug and is done under Medicare?
 
We routinely bill nuclear stress tests (78542) along with TC-99m (A9502).

Several months ago, Medicare began denying code A9502 saying they need the paper invoice for the drug on file, which seemed egregious. We called Medicare, who said to include the name of the drug, the dosage, and the invoice amount in the 'additional info' line on the claim.

We've done that and we're still getting denied. What am I doing wrong here? Is it possible that we actually have to send the paper invoice for every stress test that involves this drug and is done under Medicare?
Who is your MAC?
 
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