J1642

This code is for a port flush drug, heparin. Trailblazer and NHIC have it bundled into the drug administration codes. But, it is not a CCI edit...do you think it is a billable drug to other MACs? To other payers?

re: J1642

Not if the payor interprets the CPT® manual literally. We went round and round with United HealthCare and others years ago because they were paying pennies on the heparin, and denying the port flush CPT® code. We now bill the flush CPT® without the heparin HCPCS and get at least $25.00 depending on contractual reimbursement. See the previous forum post re: port flush here:
http://www.codapedia.com/topicOpen.cfm?id=0B3CBD06-A0E6-4E57-8663B475B69DFA22