I'm new to this listserve, so I apologize if this question has already been
discussed...

We are in the process of addressing our current provider contracts that
contain custom / home grown codes.  The area that we are having the most
difficulty is with home health care and infusion therapy contracts.  The way
that most home health care contracts are written, there just isn't enough
current codes to cover all of the different services and levels of services
that could be provided.  With infusion therapy, the pharmaceutical piece and
supplies are an issue, especially if we have to go back to J-codes.  

Even in talking with the service vendors themselves, thinking that they will
be dealing with this same issue with all of their payers, they have not been
able to offer much assistance.  Any thoughts or feedback on how others are
addressing this issue, or if you're stuck too?

Thanks,
Steven Robino
Coventry Health Care


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