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Miltenyi Biotec distribution:
As a global market leader with numerous subsidiaries and distributors, Miltenyi Biotec is committed to providing our customers around the world with the highest quality products. In addition to direct selling in more than 20 countries in North America, Europe and Asia/Pacific, Miltenyi Biotec also provides support for our customers through an extensive distributor network covering dozens of additional countries.
As a global market leader with numerous subsidiaries and distributors, Miltenyi Biotec is committed to providing our customers around the world with the highest quality products. In addition to direct selling in more than 20 countries in North America, Europe and Asia/Pacific, Miltenyi Biotec also provides support for our customers through an extensive distributor network covering dozens of additional countries.
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As preparation for reviewing the remainder of this website, it is valuable to understand several standard concepts of reimbursement. Before any product can be deemed "reimburseable," there must be three components in place within a payer:
Please refer also to downloads and references for more information on reimbursement tools and society websites.
In October of 2010, the Centers for Medicare and Medicaid Services (CMS) created separate Diagnostic-Related Groups (DRGs) to delineate inpatient coverage between allogeneic and autologous transplants.
As of October 2010, the DRG used for coding inpatient allogeneic transplants is DRG 014. (Previously, autologous and allogeneic patients had been grouped into MS-DRG 009) For complete information regarding the Medicare DRG’s and inpatient coding go to the Dept. of HHS Medicare Reimbursement website.
The outpatient transplantation code for reimbursement of allogeneic-related transplantation is CODE 38240. Though this code is specific to allogeneic-related transplant settings, it is combined with the allogeneic unrelated code for the Ambulatory Procedure Code APC 112.
Additional information regarding Medicare and Medicaid reimbursement may be found by following the link: www.cms.hhs.gov.
In 2008, Medicare began to recognize commonly used CPT codes applicable to inpatient allogeneic transplants. Click here for a list of codes typically used in stem cell transplantation for Acute Myeloid Leukemia.
Additional information regarding coding and billing may also be found in the websites of various societies involved in stem cell transplantation. These include:
If you have an AML patient that qualifies for treatment and is covered by Medicare or Medicaid, click here for a template that may be used to facilitate this coverage discussion.
Private health plans are funded by commercial insurance companies. They finance health care either for a particular company’s employees or for individuals who purchase a health plan on their own. Today most people with private health insurance belong to some type of managed care plan, although a few still buy private insurance for service coverage on their own.
Private insurance providers use the system called current procedural terminology (CPT) codes devised by the American Medical Association in 1966. Like their government counterpart, CPT codes communicate to the patient's insurance company what medical, surgical and diagnostic services were performed by medical personnel.
Click here for a list of codes typically used in stem cell transplantation for Acute Myeloid Leukemia.
Additional information regarding coding and billing may also be found in the websites of various societies involved in stem cell transplantation. These include:
If you have an AML patient that qualifies for treatment and is covered by private insurance, click here for a template that may be used to facilitate this coverage discussion.
Additionally, here is a list of forms and internal documents you might need to submit to the patient’s insurance company in order to obtain authorization to use the CliniMACS® CD34 Reagent System
If your transplant program has been denied reimbursement of ex vivo T cell depletion procedures by a private payer, you can appeal this decision. Here is what you can do:
Click here to view or download a sample letter that may be used to support an appeal for insurance reimbursement if coverage has been denied.
Humanitarian Device
Authorized by U.S. Federal Law for use in the treatment of patients with acute myeloid leukemia (AML) in first complete remission. The effectiveness of the device for this use has not been demonstrated.
Indications for Use
The CliniMACS® CD34 Reagent System is indicated for processing hematopoietic progenitor cells collected by apheresis (HPC, Apheresis) from an allogeneic, HLA-identical, sibling donor to obtain a CD34+ cell-enriched population for hematopoietic reconstitution following a myeloablative preparative regimen without the need for additional graft versus host disease (GVHD) prophylaxis in patients with acute myeloid leukemia (AML) in first morphologic complete remission.
Contraindications
Do not use CD34+ cells prepared with CliniMACS CD34 Reagent System in patients with known hypersensitivity to murine (mouse) proteins or iron dextran.
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