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Does Medicare pay for A9579 Gadolinium?

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Author Topic: Medicare and A9579 Gadolinium  (Read 3160 times)

mstilger

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Medicare and A9579 Gadolinium
« on: October 07, 2011, 03:52:32 PM »
We have a patient who came in for an MRI and I received a denial from her Medicare replacement plan Secure Horizons AARP and they are denying the gadolinium charge and the denial states "We will not pay for Ambulance Services because": A9579-injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified is not a Medicare covered benefit and is excluded from the coverage under Secure Horizons.
I worked for a Radiology company prior to coming to ortho and neuro and they always covered this but usually they would request an invoice. anyone have any answers.
Thanks
Michele

Michele

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Re: Medicare and A9579 Gadolinium
« Reply #1 on: October 07, 2011, 06:06:22 PM »
I would file an appeal with Secure Horizons including the claim, the invoice, and any other info you have to support the services, as well as information showing that it is a Medicare covered service.  Usually you can find info on the CMS website under the NCD's or LCD's to support that it is covered.
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