The purpose of this web page is to offer information to providers and payers regarding reimbursement for Axumin® (fluciclovine F 18). Reimbursement information and processes will evolve over time, as they do with any prescription drug. It is recommended to revisit this website periodically for the most up to date information.
Blue Earth Diagnostics, Inc. has established a reimbursement support hotline as a resource to assist customers with questions regarding Axumin reimbursement. Reimbursement Support can be reached via telephone or email at the following contact points:
Telephone support is available Monday through Friday, from 9AM to 5PM Eastern time.
A list of frequently asked questions regarding Axumin reimbursement is available for download here.
These FAQs include information on the NDC number, reimbursement codes, and other pertinent information. If you have additional questions, please contact Reimbursement Support via the telephone number or email listed above.
New for 2017
Axumin received Transitional Pass-Through Status in the Hospital Outpatient Prospective Payment System 2017 Final Rule from CMS (Centers for Medicare & Medicaid Services). This pass-through status will go into effect on January 1, 2017. More information is available for download here.
Annotated claims forms
To assist health care professionals in submitting claims for Axumin, Blue Earth Diagnostics has provided example claims forms. Health care professionals may choose to use these forms as a reference when completing claims for Axumin.
Download an example CMS-1500 Health Insurance Claims
Download an example UB04 form
Helpful tips for prior authorizations, pre-determination, and appeals
This Easy Tip check list can assist you in gaining access to Axumin if health care professionals need to navigate a prior authorization, pre-determination, or appeal. This is not a guide or instructions, and may be used in conjunction with the Reimbursement FAQs above. Note that providers have the ultimate responsibility to ensure correct prior authorization, appeal and denial policies are followed.
Get helpful tips for prior authorizations, pre-determination, and appeals
The information on this website contains factual information and is not intended to be legal or coding advice. Blue Earth does not guarantee coverage or reimbursement for Axumin. The existence of billing codes does not guarantee coverage and payment. Payer policies vary and may change without notice. It is the provider's responsibility to determine and submit accurate information on claims. This includes submitting proper codes, modifiers, charges, and invoices for the services that were rendered. It is the provider's responsibility to ensure that all information on a claim is accurate. It is the provider's responsibility to check with the payer to determine whether the information contained on the claim is accurate. It is the responsibility of the provider to document the medical necessity of Axumin in the medical record.