Forum - Questions & Answers

May 27th, 2011 - cdarcey75

B-12 Injections and Medicare

Medicare has been putting our 96372 and J3420 codes to patient responsibility. We are using diagnosis 266.2. When the patient called Medicare they were told that we were coding it as if the patient was supplying their medication but, of course they wouldn't tell him what the correct coding should be. Can anyone help? My searches are coming up empty.
Thank you!

May 27th, 2011 - nmaguire   2,606 

re: B-12 Injections and Medicare

Covered for:
266.2* Cyanocobalmin deficiency
281.0*–281.1* Other deficiency anemias
Note: Codes 266.2* and 281.1* as the primary diagnosis require a secondary
(dual) diagnosis from the table below.
281.3* Other specified megaloblastic anemias, not elsewhere classified (combined folateB12 deficiency anemia)
Note: No secondary diagnosis is required for codes 281.0*, 281.3* and V58.11*.
V58.11* Encounter for antineoplastic chemotherapy
Note: Use code V58.11* when administering vitamin B-12 as a part of a regimen
that includes pemetrexed (Alimta®
) (J9305).
The following are secondary (dual) diagnoses to be used with codes 266.2* and 281.1* (primary
diagnosis) to meet limited coverage for HCPCS code J3420:
123.4* Diphyllobothriasis, intestinal
Note: Use 123.4* only with primary diagnosis code 281.1.
336.2 Subacute combined degeneration of spinal cord in diseases classified elsewhere
357.4 Polyneuropathy in diseases classified elsewhere
357.81 Chronic inflammatory demyelinating polyneuritis
555.0–555.2 Regional enteritis
556.0–556.6 Ulcerative colitis
564.2 Postgastric surgery syndromes
577.1 Chronic pancreatitis
579.0–579.2 Intestinal malabsorption
579.8 Other specified intestinal malabsorption



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