j1599

does anybody know how to get this CPT® J1599 paid... w/mcare?

re: j1599

Medicare coverage status is up to Carrier judgment.When Not Otherwise Classified (NOC) drug codes J1566 or J1599 are billed for miscellaneous immunoglobulin drugs, the claim must be accompanied by a clear statement identifying the drug provided (brand or generic name, dosage strength) and the amount dispensed. Centers for Medicare and Medicaid Services (CMS):
Medicare covers intravenous immune globulin (IVIG) when criteria is met. See the Medicare Benefit Policy Manual (Pub. 100-2) Chapter 15 - Covered Medical and Other Health Services, Section 50.6 Coverage of Intravenous Immune Globulin for Treatment of Primary Immune Deficiency Diseases in the Home at http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf
Medicare also covers IVIG for the treatment of biopsy-proven (1) pemphigus vulgaris, (2) pemphigus foliaceus, (3) bullous pemphigoid, (4) mucous membrane pemphigoid (also known as cicatricial pemphigoid), and (5) epidermolysis bullosa acquisita when criteria are met. See the National Coverage Determinations (NCD) for Intravenous Immune Globulin for the Treatment of Autoimmune Mucocutaneous Blistering Diseases (250.3).
United Health Care Policy: https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Drug%20Policies/IVIG_policy.pdf