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Thread: Coding Marcaine with Medicare

  1. #1

    Question Coding Marcaine with Medicare

    AAPC: Back to School
    I am asking for any input on billing Medicare for Marcaine. According to their guidelines, they require you to use J3490 unclassifed drug - with an explanation and the NDC # listed, where as BCBS and the rest of the insurance companies use the actual S0020 which is specified for this particular drug. But, I am still getting rejections from Medicare with this information even after I spoke with a supervisor at Medicare
    Thanks, AJ

  2. #2
    Join Date
    Apr 2007

    Default Marcaine

    Hi, Mcare doesn't cover Marcaine using the S code. I checked the NCCI edits and it is excluded by Medicare. Sorry.

  3. #3

    Default Sometime Pay

    Thing is I have received Medicare payments at times, with special TLC on this code and resubmittals with the TCN #'s, but I was just looking to see if anyone new something that I might not! Thanks for your input, I do appreciate it.

  4. #4
    Join Date
    Apr 2007


    keep in mind....just because you are getting paid...doesnt mean its right. You may end up having to refund Medicare.
    Mary, CPC, CANPC, COSC

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