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Thread: A4212

  1. #1
    Join Date
    Apr 2007

    Default A4212

    AAPC: Back to School
    I am looking for some advice on billing the A4212 code w/chemo administration. I have heard from some sources that it is billable, but we are having problems w/reimbursement from Medicare.
    Is it billed as a DME?
    Is anyone else having any luck getting reimbursed?
    Any input is greatly appreciated.

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota

    Default Bundled code

    Medicare considers this a bundled code and as such will not pay for it separately. If your commercial insurances base their fee schedule/reimbursement policies on Medicare, they won't pay for it either. You should check with each insurance company you are contracted with; but I really think most of them will also deny it as bundled.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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