Community Chat

[RibbonsRosesRainbows]

b-12 and B shots anymore per my elderly friend........so without Medicare the shot cost $40 and he has to have them weekly.......so a friend of his is a nurse RN and she is going to give him the shots......the doctor will write the prescription for the B12 and B vitamins and the RN that goes to church with him will give him the shots.......I wonder why else they have quit paying for?

[tansy]

I don't believe your friend got accurate info, R&R.

[pitdakota]

This is an internet hoax that has been going around since health care reform was first being discussed. One can even look it up on Snopes.

Medicare has always only reimbursed for vitamin B-12 injections for certain diagnosed conditions. That has not changed, they still pay for the B-12 injections for a list of diagnoses. And those conditions that need to be diagnosed before Medicare will pay for B-12 injections hasn't changed over time, either. In fact, it has been expanded over the past several years.

[tansy]

Thanks, pitdakota. I didn't want to mention Snopes for some reason:-/

[minkbunny]

Hi R and R - hope you are feeling well.

This article is from last year so perhaps the qualification requirements have changed -

Intravenous, intramuscular, or subcutaneous injections and infusions, and hypodermoclysis or intravenous feedings require the skills of a licensed nurse to be performed (or taught) safely and effectively. Where these services are reasonable and necessary to treat the illness or injury, they may be covered. For these services to be reasonable and necessary, the medication being administered must be accepted as safe and effective treatment of the patient's illness or injury, and there must be a medical reason that the medication cannot be taken orally. Moreover, the frequency and duration of the administration of the medication must be within accepted standards of medical practice, or there must be a valid explanation regarding the extenuating circumstances to justify the need for the additional injections.

Vitamin B-12 injections are considered specific therapy only for the following conditions:

• Specified anemias: pernicious anemia, megaloblastic anemias, macrocytic anemias, fish tapeworm anemia;
• Specified gastrointestinal disorders: gastrectomy, malabsorption syndromes such as sprue and idiopathic steatorrhea, surgical and mechanical disorders such as resection of the small intestine, strictures, anastomosis and blind loop syndrome, and
• Certain neuropathies: posterolateral sclerosis, other neuropathies associated with pernicious anemia, during the acute phase or acute exacerbation of a neuropathy due to malnutrition and alcoholism.

For a patient with pernicious anemia caused by a B-12 deficiency, intramuscular or subcutaneous injection of vitamin B-12 at a dose of from 100 to 1000 micrograms no more frequently than once monthly is the accepted reasonable and necessary dosage schedule for maintenance treatment. More frequent injections would be appropriate in the initial or acute phase of the disease until it has been determined through laboratory tests that the patient can be sustained on a maintenance dose.

(edited by me to make a word plural)

[Marp2]

In addition to what Pitdakota and Minkbunny posted great care needs to be taken with billing codes. A simple coding error can and will cause rejection of the claim.

Hi Pit and Minky. Hope all is well with both of you. Minky, looking forward to hearing the tractor is in the field.

[RibbonsRosesRainbows]

Thank you all.......I know that when I was sick in the winter and could not get well the third doctor gave me a b12 shot with a steroid shot and I was better.....I think it paid for that so maybe my elderly friend did not understand his doctor. They were talking about it at church last night.

[minkbunny]

On 5/25/2014 Marp2 said:

In addition to what Pitdakota and Minkbunny posted great care needs to be taken with billing codes. A simple coding error can and will cause rejection of the claim.

Hi Pit and Minky. Hope all is well with both of you. Minky, looking forward to hearing the tractor is in the field.

Thanks, Marp. We're getting there

[pitdakota]

O/T...Hi Minky, Marp, and Topsy!!

Topsy, "the letter" was sent to me via email more than a year ago. Something along the lines "I went to the doctor today for my routine B-12 shot I have been getting for years and found out Medicare will no longer pay" yada yada. So I recognized the content right away.

Marp, doing okay here and hope you are doing okay as well. I will stay away from Minky's tractor though. I would not want to be responsible if I were driving a tractor!

R&R, I think your friend just didn't get very good information.

[tansy]

Am I Topsy? LOL. I like it. If I am banned, that's my new nic