Re: BMT Medicare coverage for ALLO

[Guest guest]

Medicare's coverage language states that they cover allo BMT for leukemia and leukemia in remission. They don't specify sub-types. Even if it evolved from myeloma, they're covering the leukemia and not the myeloma. I think you were wise to play it safe by obtaining auth from the secondary, though. Goldstein Stanford BMTSent from my iPhone Hello!Our Center has just been paid for an allo by Medicare for diagnosis 203.10 Which is Plasma Cell LeukemiaWe did not think that Medicare would pay for that diagnosis and we were prepared to bill MO Medicaid after we received a denial from Medicare.I'm just wondering if this is usual, or if Medicare made a mistake.Any advice is greatly appreciated!!Thank you!Kim , TFCBMT Jewish HospitalSt. Louis, MO

[Guest guest]

Medicare's coverage language states that they cover allo BMT for leukemia and leukemia in remission. They don't specify sub-types. Even if it evolved from myeloma, they're covering the leukemia and not the myeloma. I think you were wise to play it safe by obtaining auth from the secondary, though. Goldstein Stanford BMTSent from my iPhone Hello!Our Center has just been paid for an allo by Medicare for diagnosis 203.10 Which is Plasma Cell LeukemiaWe did not think that Medicare would pay for that diagnosis and we were prepared to bill MO Medicaid after we received a denial from Medicare.I'm just wondering if this is usual, or if Medicare made a mistake.Any advice is greatly appreciated!!Thank you!Kim , TFCBMT Jewish HospitalSt. Louis, MO

[Guest guest]

Thank you !

We have Medicare Guidelines that we reference that include actual ICD 9 codes

but 203.10 is not listed. That is why we thought they wouldn't pay.

I should just be glad they did!

Thanks again!

Kim

>

>

>

> Hello!

>

> Our Center has just been paid for an allo by Medicare for diagnosis 203.10

Which is Plasma Cell Leukemia

>

> We did not think that Medicare would pay for that diagnosis and we were

prepared to bill MO Medicaid after we received a denial from Medicare.

>

> I'm just wondering if this is usual, or if Medicare made a mistake.

>

> Any advice is greatly appreciated!!

>

> Thank you!

>

> Kim , TFC

> BMT

> Jewish Hospital

> St. Louis, MO

>

>