Please be advised that there has been a lot of talk about convenience kits or injections kits as a reimbursable product for the medical groups.

The J codes created for these kits are a combination of the medication plus supplies. However, since the medication itself already has a procedure code and policy dictates that supplies are an inherent part of the injection reimbursement, these new kits are skirting a grey area of compliance and not being coded correctly.

Correct coding bundles the kit with the injection and it is not appropriate to bill separately.

Many companies have been going around selling doctors on entering into these agreements with legal back doors of becoming 'investors' on the pharmacy side to receive income from releasing these kits under the pharmacy benefit.

While these ventures will surely produce income now... it is inevitable that it will not last very long.

Please see released statement from Highmark. The insurance companies are becoming wise on these "kits" and will no longer be paying for them.

Please speak with me individually for details.

See released update here: https://www.highmarkblueshield.com/health/pdfs/pubs/sb-prescription-drug-cvg-convenience-kit-products-081516.pdf