As a dermatology coder, you will be faced with various challenges relating to your coding; even when it comes to Healthcare Common Procedure Coding System (HCPCS), you will come face to face with various HCPCS coding challenges .
For instance you may find yourself bowled over by a question such as this: When the dermatologist carries out photodynamic therapy, can you code separately for the Levulan Kerastick? Do we have a HCPCS code for this supply?
You should go for a HCPCS code (Aminolevulinic acid HCl for topical administration, 20%, single unit dosage form [354 mg]) for the supply of 5-aminolevulinic acid cream (also called ALA) and sold under the brand Levulan Kerastick. Most payers will give money back for the agent, which reacts under light to destroy lesions during the photodynamic therapy procedure. But you should make an effort to check with your local contractor to ensure it will recognize and reimburse for the HCPCS code.
To know about what HCPCS code to apply for AVA cream as well as know more about HCPCS coding and ways to wriggle out of tough coding situations, sign up for a one-stop medical coding guide. When you do so, the site will provide you the indexing of HCPCS codes as well as CPT or ICD codes. No wonder such a site provides very comprehensive and powerful keyword search functionality. Such a site does not pinch your pocket too as it can be had for a small amount.
So go sign up for one today and give more bones to your coding!
Wednesday, April 27, 2011
HCPCS 2011 Brings new Options for Lymph Cancer Drugs
When all other treatments have failed, take a look at these drugs
You’ll have three new J codes for leukemia and lymphoma treatments available for use in January, 2011.
J9302 answers call for Arzerra Code
If you provide Arzerra injections, you should take note of new code J9302 (Injection, ofatumumab, 10 mg). Oncologists normally use the medication to treat chronic lymphocytic leukemia in adults who haven’t responded well to fludarabine or alemtuzumab.
As the suffix -mab in ofatumumab points to, this medication is a monoclonal antibody.
Remember: Earlier, hospitals had a C code available for this agent, C9260 (Injection, ofatumumab, 10 mg). However this code makes an exit in the latest HCPCS code sets. (Note that C codes are appropriate only for Hospital Outpatient Prospective Payment System claims.)
Train eyes on J9307 for Folotyn
One more new J code for 2011 is J9307 (Injection, pralatrexate, 1 mg), which is just right for Folotyn.
Oncologists normally use this folate analogue metabolic inhibitor to kill cancer cells in patients with peripheral T-cell lymphoma that hasn’t responded to other medications or has returned.
HCPCS 2011 also axes the C code available to hospitals for this drug, C9259 (Injection, pralatrexate, 1 mg).
Flip to J9315 for Romidepsin
If your documentation shows your practice supplied Istodax, you have J9315 (Injection, romidepsin, 1 mg) at your service in the new year. The drug is a histone deacetylase inhibitor that slows the growth of cancer cells. It is intended for use in patients with cutaneous T-cell lymphoma who have been treated earlier with another drug.
In 2010, hospitals use C9265 (Injection, romidepsin, 1 mg) for this drug, however HCPCS 2011 deletes this code.
For a quick look at the HCPCS code changes, sign up for a medical coding guide like Supercoder!
You’ll have three new J codes for leukemia and lymphoma treatments available for use in January, 2011.
J9302 answers call for Arzerra Code
If you provide Arzerra injections, you should take note of new code J9302 (Injection, ofatumumab, 10 mg). Oncologists normally use the medication to treat chronic lymphocytic leukemia in adults who haven’t responded well to fludarabine or alemtuzumab.
As the suffix -mab in ofatumumab points to, this medication is a monoclonal antibody.
Remember: Earlier, hospitals had a C code available for this agent, C9260 (Injection, ofatumumab, 10 mg). However this code makes an exit in the latest HCPCS code sets. (Note that C codes are appropriate only for Hospital Outpatient Prospective Payment System claims.)
Train eyes on J9307 for Folotyn
One more new J code for 2011 is J9307 (Injection, pralatrexate, 1 mg), which is just right for Folotyn.
Oncologists normally use this folate analogue metabolic inhibitor to kill cancer cells in patients with peripheral T-cell lymphoma that hasn’t responded to other medications or has returned.
HCPCS 2011 also axes the C code available to hospitals for this drug, C9259 (Injection, pralatrexate, 1 mg).
Flip to J9315 for Romidepsin
If your documentation shows your practice supplied Istodax, you have J9315 (Injection, romidepsin, 1 mg) at your service in the new year. The drug is a histone deacetylase inhibitor that slows the growth of cancer cells. It is intended for use in patients with cutaneous T-cell lymphoma who have been treated earlier with another drug.
In 2010, hospitals use C9265 (Injection, romidepsin, 1 mg) for this drug, however HCPCS 2011 deletes this code.
For a quick look at the HCPCS code changes, sign up for a medical coding guide like Supercoder!
Away from Level II edit pairs or miss drug screen pay
With effect from July 1, owing to the CCI edits version 16. 2, you have plenty of new pairs to stay on top of for your lab. CMS urges labs to report the following new 2010 HCPCS Level II codes for certain drug screen testing for Medicare beneficiaries.
The agency provides further coding instruction in the form of CCI edit pairs that restrict the use of these codes. The latest CCI 16.2 bundles G0430 with chromatography codes 82486-82489 (Chromatography, qualitative ). Likewise, you have new pairs bundling G0431 with 83516-83518.
The drug screen G codes describe testing using a particular method and you should not additionally report a code for the method.
The latest edits also bundle the drub screen G codes with lab consultation codes 80500-80502 (Clinical pathology consultation …).
Tele-health or consult – go for one
If you are reporting HCPCS Level II codes for physician telehealth services, the latest CCI codes ensure you don’t report those codes together with a clinical lab consultation.
For more on the latest CCI codes and HCPCS Level II codes, sign up for a one-stop medical coding website. When you register yourself for one, you can do a HCPCS 2010 code look up and get all the information you need to know. Onboard such a site, you will also get reimbursement tools like CCI edit alerts that will help you stay up to date on all changes relating to CCI codes. In fact, such a site will provide you with all the coding information you need to stay on top.
The agency provides further coding instruction in the form of CCI edit pairs that restrict the use of these codes. The latest CCI 16.2 bundles G0430 with chromatography codes 82486-82489 (Chromatography, qualitative ). Likewise, you have new pairs bundling G0431 with 83516-83518.
The drug screen G codes describe testing using a particular method and you should not additionally report a code for the method.
The latest edits also bundle the drub screen G codes with lab consultation codes 80500-80502 (Clinical pathology consultation …).
Tele-health or consult – go for one
If you are reporting HCPCS Level II codes for physician telehealth services, the latest CCI codes ensure you don’t report those codes together with a clinical lab consultation.
For more on the latest CCI codes and HCPCS Level II codes, sign up for a one-stop medical coding website. When you register yourself for one, you can do a HCPCS 2010 code look up and get all the information you need to know. Onboard such a site, you will also get reimbursement tools like CCI edit alerts that will help you stay up to date on all changes relating to CCI codes. In fact, such a site will provide you with all the coding information you need to stay on top.
PM claims: Go with the latest HCPCS codes
Go with the latest HCPCS codes
You are a pain management coder and you are facing new CPT codes for posterior intrafacet implants, paravertebral facet joint injections, and sacroplasty. But as you gear up to implement these changes, don’t overlook changes to HCPCS codes for bolulinim toxin injections and implantable neurostimulator electrodes.
You will have to double check calculations before filing claims what with a new code for botulinum toxin type A and revisions to the older codes for botulinum toxin types A and B.
The latest addition to your botulinum toxin choices is J0586.
HCPCS 2010 brings about revisions to the existing botulinum toxin codes. The new descriptors are J0585 -- Injection, onabotulinumtoxinA, 1 unit, J0587 -- RimabotulinumtoxinB, 100 units.
The change is important for various reasons. One reason is it emphasizes that the medications are not interchangeable by structuring the codes differently, it differentiates botox from Dysport, it simplifies fee calculations because of separate codes.
Also, you’ll do well to know that a change to L8680 will have a big impact on your coding if you bill an office site of service setting. The previous descriptor for L8680 read Implantable neurostimulator electrode, each. The new descriptor effective with HCPCS 2010 is Implantable neurostimulator electrode (with any number of contact points), each.”
As a pain management coder, you’ll certainly stand in good stead if you stay up to date on these codes. If you are unsure where you can go to for the latest on HCPCS codes, the best bet would be to go for a one-stop coding website where you can discover a sea of information pertaining to HCPCS codes.
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