ollielooya
True Blue
Hope someone is around this weekend to answer this post. Doctor provides services in his office with Remicade infusions. In addition to that he provides a steriodal drip prior to giving the infusions which is also denied. For this particular patient with a 696.0 diagnosis, Aetna has denied the 96413 and 96415 for missing the required HCPCS code of J1745. We do not bill the drug to Aetna as patients gets this from an off-site pharmacy. So, to unlock the claims edits, do we submit the HCPCS code on the HCFA and charge "0" or .01 charge? Is this the accepted way to unlock the McKesson edits?