My name is Toni and I work in pain management so I do pump refills all the time. Until I figured out why my reimbursements for the drug codes were so low I was sooo confused
for pump refills I code 62368,95970,A4220, and the drug codes (for the Dr. I use 95971 instead of 95970)--only thing with the drug codes are you have to make sure the pharmacy filling your rx is using the correct measurement per unit for the drugs as the insurance company; (Example fentanyl J3010 measures in MG not MCG ). this will make a hugh difference in the reimbursement. Your pharmacy should be glad to assist you and will change the billing units also.
You can go on line to the different insurance companies and pull up the drugs in the physician fee schedule and most of them will show the measurements per unit.
I hope this helps
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