04/20/2022

Important Message from BCBSM to MSHO Members

Neulasta - J2506 - Be Careful Your NDC Units of Measure AND your HCPCS Units are Correct!

Here’s an update in response to the Neulasta claims for both Professional and Facility. 

Please remind providers to continue using RC Claims Assist tool.  We found with most of the Professional Neulasta claims that were adjusted as you may have noticed a slightly lower reimbursement on some.

On the Professional side:

Please continue using the RC Claims Assist tool for appropriate NDC billing
Some claims were billed with NDC unit of 0.64ML, the NDC unit is 0.60 ML, as shown in the image below from RC Claims Assist

• Please continue using the RC Claims Assist tool for appropriate NDC billing
• Some claims were billed with NDC unit of 0.64ML, the NDC unit is 0.60 ML, as shown in the image below from RC Claims Assist

On the facility side:

Some facility claims only paid 1 HCPCS unit because the MIQTYMAX table wasn’t updated to 12 HCPCS units until 2/21/22.  These claim are being reviewed and adjusted if applicable.

Also please make sure Facilities are billing the correct HCPCS units.  We found that some facilities only billed 1 HCPCS unit in error instead of 12 HCPCS units.  The payment is low, but correct due to the # of HCPCS billed.