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Thread: IT Pump Refills

  1. #1

    Default IT Pump Refills

    AAPC: Back to School
    Is anyone else having trouble getting paid for compounded drugs in pump refills?

    We can billing 62368 95991 and J3490

    as of November 1st we no longer fax invoices but instead listed dosages in box 19

    I have a calculator that a Medtronic Rep left with us that I guess multiplies the drug concentration by the pump volume to calculate the total mg or units along with estimating medicare's total allowable, and I have been billing with these units (in box 19, not in 24G).

    We got paid $55 dollars for medications we paid atleast double for, and I thought Medicare was supposed to be including a $60 flat pharmacy compounding fee in each of the payments for J3490.

    Can anyone explain to me what the proper method for billing is? Maybe I am mistaken? Should I appeal??

    Thank you!
    Last edited by LuluBarr; 03-02-2011 at 02:50 PM. Reason: for specificity

  2. #2


    yeah, we just received payment for more of our patients of like $55.71 and $58 for medications we paid $225 for. Isn't medicare atleast supposed to be paying the $60 pharmacy compounding fee?
    Last edited by LuluBarr; 03-16-2011 at 12:37 PM.

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