I am trying to find the best way to code and bill for the drugs that go into an intrathecal infusion pump. From what I have found out so far the code to use is J7799 and the discription of the drug and NDC # has to be in the narrative.
Since we are a pharmacy that also provides DME and are only billing the drugs we have been told by Trailblazer Medicare that our bills will go to CIGNA Medicare DMERC. Also when billing to CIGNA the KD Modifier is not used like it is when you bill this code to Trailblazers. Our issue with this is that CIGNA does not have an Internal Infususion pump LCD in place and therefore they have denied payment also. If anyone has experience in this matter please give me some suggestions. At this time we have sent in all of our records with our claims to CIGNA and are playing the waiting game to see what they will decide. Has anyone out there been thru this with Medicare for this code? If you have, Please tell me what the outcome was and what you had to do to get payment. Thank you in advance!!