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Wiki injectables unclassified biologic

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caresource marketplace denied J3590 injectable for invalid ndc
 
We are also having issues with Avastin J3590 for Ophthalmology use with all Caresource IN plans. They are denying due to NDC: 50242-0060-01 for compounded Avastin 1.25mg, billed with 1 unit stating "M119 - Missing/incomplete/invalid/ deactivated/withdrawn National Drug Code (NDC).". We have filed disputes including Caresource's pharmacy policy that states "J3590 will be reimbursed as follows, when billed with NDC 50242-0061-01 or 50242-0060-01: 1. For units 1 to 1.25, reimbursement is up to $70.00 per eye, per calendar month." Caresource is denying our disputes stating "50242-0060-01 is an invalid NDC code ". Have you had any luck getting Caresource to process claims correctly?
 
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