Wiki J0885 denials

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katelliott80

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Is anyone else getting denials on J0885 EA? I can not find any new policy on the CMS website pertaining to chemo induced anemia. We did find an updated change starting 10/1/09 with some of the renal codes. Where it was getting confusing was this:

V5869 Use this to indicate that the chemotherapy induced the anemia for OTHER THAN neoplastic disease or following stem cell transplantation and associated immunosupression. This would not be used for neoplastic disease since that coverage is outlined in an NCD.

I looked at the only NCD I could find which was dated in 2008. These denials started in Oct 09.

We currently bill it like this 285.8, 995.20, then the cancer dx.

Anyone know where to find a new policy?? There has to be one that I am missing. Can someone send me a link?

Thanks so much !!!
 
Im in Florida and this is how we have to bill according to the LCD ..if it is chemo induced anemia then it should be the J code w/ 285.3 and the cancer dx ** there must be 2 dx on the J code .. .and the ONLY anemia code they are allowing is the 285.3
96372 with the cancer dx

HOpe it helps ... I have been at work on this for the last 4 months ... and most of our denials from May are now paid ! Whoo hoo !
 
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