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Wiki Injection denials/ Eylea/Lucentis

wbell74

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FALMOUTH, ME
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Hello,

We are getting tons of injection denials from almost all insurance companies requesting notes for bilateral eye injections. Is anyone getting them ? And if not, how do you bill on the claim?

We currently bill the total units of the drug on one line but have tried in the past billing separating each side -so the insurance can see that we put in 2 units each eye.


HELP ! :)
 
Hello,

We are getting tons of injection denials from almost all insurance companies requesting notes for bilateral eye injections. Is anyone getting them ? And if not, how do you bill on the claim?

We currently bill the total units of the drug on one line but have tried in the past billing separating each side -so the insurance can see that we put in 2 units each eye.


HELP ! :)

More information would be helpful. What does the denial state? What dx code did you use? How exactly did you bill the procedure?
 
Are they putting Eylea and Lucentis in both eyes? I've never seen that. But I bill all eye procedures using RT and LT.
 
i have been having the same issues and they are recent issues. i am anxiously waiting my corrected claims to see if i fixed the issue or if i will have to call and find out if there is some kind of policy change...again
 
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