Wiki J9047 with 96409

[zaidaaquino]

One set of codes we have billed is J9047 with 96409. I have an insurance company that paid on the drug but says that 96409 cannot be billed with it. As far as my research goes, 96409 is the correct code. But now I'm second guessing myself...can someone shed some light on this? Thanks.

Zaida Aquino

 

[mlemon]

J9047 and 96409

According to the Kyprolis billing information online, 96409 is an appropriate admin code for J9047.

Is the carrier Humana by chance? Recently we have received denials on 96409 when billing appropriate J codes.

Here is the link from the drug company website:

http://www.kyprolis.com/Areas/Hcp/content/pdfs/KYPROLIS Coding and Billing Reference.pdf

 

[zaidaaquino]

Thanks for the info...

Zaida

 

[CFisher5]

I have had this issue with Aetna. They deny the admin codes but only for certain drugs (of course they are expensive ones like J9354 and J9047). I have been working on this for a few months now and it is a glitch in their system that I can't get fixed. Unfortunately I have to appeal every single one of these.

 

[zaidaaquino]

Thanks cfisher5. That's precisely the insurance that's denying this code. Appeal this I will...thanks.