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ASP DME infusion payment limit

Lori Posted Wed 29th of October, 2014 18:34:17 PM

When billing J0475 for a pump refill any suggestions on how to get the insurance carrier to price the J0475 using the DME infusion payment limit? They are having a hard time acknowledging -KD. Or do you know of any documentation regarding -KD. I have a Noridian Bulletin from 2006 but since Medicare hasn't made any changes they haven't done any other Bulletins since then.

SuperCoder Answered Thu 30th of October, 2014 06:57:08 AM

Thank you for your question.

You are correct that there have not been any documented changes from Noridian since 2006. Have you tried reaching out to Noridian for any suggestions? Modifier -KD is correct when coding/billing J0475. Verify appropriate diagnosis and submit with supporting documentation for pricing.

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