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Drug
Coding, Billing & Part B/D Updates
R·J
Health Systems is proud
to be a new contributor to BC Advantage.
We are specialists in HCPCS and
CPT drug coding and pricing. We
present this essential information
in a user-friendly, easily accessible
format that is updated monthly.
Our goal is to assist professionals
working in the healthcare field
that are involved with billing Medicare/Medicaid
for drug therapy, including Managed
Care Organizations, Third Party
Payors, Healthcare Professionals,
Consultants and Hospitals
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Drug Diagnosis Coding " - NOW AVAILABLE!
May
2010
The following CPT codes were published on the AMA (American Medical Association) website December 22, 2009 prior to their effective date of July 1, 2010. These codes are for future use if needed for pandemic situation.
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4th Quarter ASP and NOC (Not Otherwise Classified) pricing
January
2010
CMS (Centers for Medicare & Medicaid Services) has released the 4th Quarter ASP and NOC (Not Otherwise Classified) pricing files along with revisions of previous quarters, please see below for detailed information on those revisions.
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Code Updates
November
2009
We are pleased to provide you with HCPCS Drug Code updates which will become effective 10/1/09, one new Q-Code and one discontinued S-Code. We have also included information regarding one new CPT Code which will become effective 1/1/10 and information regarding the use of CPT Code 90663 for the H1N1 vaccine and 90648 for newly approved Hiberix. You will be able to view the new HCPCS/CPT Drug Code updates on www.ReimbursementCodes.com .
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Part B or D IVIG (Intravenous Immune Globulin) Coverage Clarification
September
2009
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Part B updates
July
2009
Our article for this issue includes the following Part B updates that are based on recent communications received from CMS (Centers for Medicare & Medicaid Services). These include important coding and pricing updates that are essential for billers and coders in both the hospital and private or group healthcare professional setting.
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Medicare Part D benefit
May
2009
We are pleased to provide summarizations of some key updates that will affect the Medicare Part D benefit that were communicated from CMS (Centers for Medicare & Medicaid Services). These changes are expected to impact the services billers and coders provide to healthcare professionals and payors this year. We focus first on the formulary requirements that may change for 2011 and follow that with an update detailing CMS' guidelines for healthcare professionals and their staff to help ensure beneficiary access to their Part D medications should an emergency occur.
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Bew 2009 Code Updates
March
2009
In this article we highlight a few of the significant coding and reimbursement changes effective for 2009. The coding changes from CMS (Centers for Medicare & Medicaid Services) are detailed below. Please note this is not a complete list of all 2009 HCPCS New Codes, Code Descriptor Changes and Deleted Codes, but rather codes that are specific to drugs/products appearing in ReimbursementCodes.com.
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Medicare Part B Drug Competitive Acquisition Program (CAP) Postponed for 2009
January
2009
We are pleased to provide some important updates from CMS (Centers for Medicare & Medicaid Services) that will have an impact on billing and coding practices for the rest of 2008, 2009 and beyond. Additionally, as Billers and Coders well know, the end of year brings extensive new information from CMS on new, revised and deleted codes for 2009 which always ensures a very busy end of year! Subscribers to ReimbursementCodes.com can expect to receive their supplemental newsletter detailing the code changes in November.
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Flu Vaccine Update
November
2008
On August 5, 2008 the FDA announced that they had approved this year's (2008-2009) influenza vaccines. All three strains in this year's vaccine have been changed compared with the usual one or two strains that change from year to year.
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Medicare Policy for Billing of Discarded Drugs (Wastage)
September
2008
Recently we had the opportunity to review CMS' policy regarding billing for discarded drugs (wastage). CMS' official policy on this issue applies only to single dose vials and NOT to multi-dose vials of drugs or biologicals. If providers are unable to schedule patients in a way that utilizes the full amount of a single dose vial/package of a drug/biological then payment may be obtained for both the amount administered and the remainder of the drug/biological. Payment is provided up to the amount indicated on the vial or package label, after administering the dose/quantity of the drug/biological to a Medicare patient.
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Part B or Part D - Anti-Emetic Drug(s) Info
July
2008
An oral anti-emetic drug(s) should ONLY be prescribed PER chemotherapy treatment. For example, only enough of an oral anti-emetic(s) for one 24- or 48- hour dosage regimen (depending on the drug) should be prescribed/supplied for each incidence of chemotherapy treatment.
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NEW CODES FOR 2008!
March
2008
ReimbursementCodes.com is in the process of adding the following new drug codes and new descriptors to our database and removing the list of deleted codes. These new codes become effective for Medicare for dates of service on or after January 1, 2008. If applicable, brand names are listed in parentheses.
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New 2008 Vaccine CPT Codes
January
2008
Getting prepared for all the coding and pricing changes to arrive in the new year can be challenging! Please find listed below some helpful reminders and important notes on specific drugs/products to monitor in 2008.
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Medicare billing: NEW drug codes
November
2007
There are NEW drug codes that became effective for Medicare billing for dates of service on or after July 1, 2007. Please note, CMS has not indicated they will be deleting the previous codes for these products. However, CMS has confirmed that the previous drug codes for these products were coded as non-payable under Medicare effective July 1, 2007. The codes that became non-payable are: J1567, J7611, J7612, J7613, J7614. New codes (with corresponding drug names in parentheses) that were effective July 1, 2007:
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What are B-codes?
October
2007
What are B-codes? B-codes relate to Enteral and Parenteral Therapy, including codes for supplies, formulae, nutritional solutions and infusion pumps. R·J Health Systems recently instituted a new pricing methodology on ReimbursementCodes.com for B-codes based on feedback from our clients.
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Q-Code Updates
October
2007
The four new Q-Codes are: Q4083, Q4084, Q4085, Q4086. J7319 was deleted effective March 31, 2007.
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Vaccine Reimbursement in 2008
October
2007
We have received many new and unique billing questions regarding Medicare Part B versus Part D coverage. If a vaccine is covered under Part B currently, it will continue to be covered under Part B in 2008. The following VACCINES are currently covered under Part B:
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FluLaval Update
September
2007
CPT-Codes are assigned by the AMA and used to bill for Immune Globulins, Vaccines and Toxoids. Multiple codes for a particular vaccine/toxoid are provided when the schedule differs for two or more products of the same vaccine type (e.g., hepatitis A, HiB) or the vaccine product is available in more than one chemical formulation, dosage, or route of administration. Separate codes are available for combination vaccines (e.g., DTP-Hib, DtaP-Hib, and HepB-Hib).
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CONTACT
US:
Contact Us:
Info@RJHealthSystems.com
Phone: (860) 563-1223
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