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Click here for more sample CPC practice exam questions and answers with full rationale

Intrathecal Pain Pump Billing

I need help, we are currently struggling to receive reimbursements from commercial payers and medicare.

1. Our commercial payers are denying our claims due to "exceeding max units allowed", but when converted to the appropriate units our units are accurate.

2. When commercial is primary and medicare is secondary, do you bill to commercial medicare’s j7999 or do you bill the commercial jcodes for compound meds?

3. Which is the appropriate code for medicare to use when refilling Intrathecal Pain Pumps j7799 or j7999? I cannot find a clear answer.

Thank you to anyone who can help :D!

-Karla

Medical Billing and Coding Forum