Results 1 to 5 of 5

Aranesp J0881

  1. #1
    Question Aranesp J0881
    Exam Training Packages
    My facility is having the worst time getting these injections paid by Medicare. I have followed the LCD for WPS using J0881 with 585._ and 285.21 for the diagnoses. I add EC modifier as instructed by WPS. I have the HCT and weight charted. What am I missing?

  2. #2
    Location
    Dallas Chapter
    Posts
    30
    Default
    Quote Originally Posted by JBJ View Post
    My facility is having the worst time getting these injections paid by Medicare. I have followed the LCD for WPS using J0881 with 585._ and 285.21 for the diagnoses. I add EC modifier as instructed by WPS. I have the HCT and weight charted. What am I missing?

    I worked in Hematology and Oncology so I know how hard it is to get that drug paid. It is not your fault. It's Medicare! I had to do appeals on every patient who was getting it. That could be 40 patients a month. They did start to pay them but only after I did the appeal and it took them a month to come back and pay it. I don't know what to tell you to get it paid. Let me know if you find out.
    Josalyn Smith, CPC

  3. Default
    Is your facility documenting a decrease in Aranesp dosage when the Hgb/Hct exceeds the levels specified in the local coverage determination? As the counts improve, the Medicare contractors want to see that the dosage is titrated downward.

  4. #4
    Default
    Actually, the dosage has remained the same in most patients.

  5. #5
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    Is it a part D drug? If so, it is not covered by Medicare.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

Similar Threads

  1. Aranesp W/E code
    By umcanes4 in forum Hematology/Oncology
    Replies: 1
    Last Post: 12-10-2012, 10:12 AM
  2. ESRD with Aranesp
    By chrisden_7 in forum Urology
    Replies: 2
    Last Post: 07-15-2011, 03:15 PM
  3. J0881
    By Revenuecycle in forum Hematology/Oncology
    Replies: 5
    Last Post: 08-24-2010, 08:07 AM
  4. ESA billing-J0881
    By uhlerclarem in forum Medicare Regulations
    Replies: 1
    Last Post: 03-25-2010, 02:12 PM
  5. code J0881
    By nowings1224 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-05-2009, 08:39 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.