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016.06.3-242.150. Verteporfin (Visudyne)

AR ADC 016.06.3-242.150Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 3. Ambulatory Surgical Center Provider Manual (Refs & Annos)
Section 240.000. Billing Procedures
Ark. Admin. Code 016.06.3-242.150
016.06.3-242.150. Verteporfin (Visudyne)
Currentness
A. Medicaid reimburses ASCs for Verteporfin (Visudyne), HCPCS procedure code J3396, when it is furnished to Medicaid-eligible beneficiaries.
1. Reimbursement for Verteporfin is not included in the reimbursement for the related surgical procedure,
2. Providers may bill Medicaid separate charges for Verteporfin and the related surgical procedure.
B. Claims for Verteporfin administration must include one of the following ICD diagnosis codes. (View ICD codes.)
C. Use anatomical modifiers to identify the eye(s) being treated.
D. J3396 may be billed electronically or on a paper claim.
E. NDC billing protocol must be followed for this drug. See Section 242.400.

Credits

Eff. Nov. 1, 2008; Nov. 1, 2007; May 1, 2007; July 1, 2007. Amended March 7, 2014; July 1, 2014; Oct. 1, 2015.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.3-242.150, AR ADC 016.06.3-242.150
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