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Wiki J7192

Thread starter susan.welch
Start date May 14, 2012

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susan.welch

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May 14, 2012

I have a question our retail pharmacy billed J7192(Factor XIII) to Medicare part B but it is being rejected through the clearing house stating we need to bill the correct payor/contractor. I called Medicare and they said it will pay under part B under special situations and I looked on the LCD and we billed it with 286.0 which is covered under the LCD. but all the articles we have read it takes us to inpatient and or SNF. So my question is should this have been billed to Medicare part A?

Last edited: May 14, 2012

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