- Added on Friday, January 01, 1982
- Status changed on Wednesday, January 01, 2003 to: No maintenance for this code
- BETOS Classification: Ambulance
- Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
Monday, July 9, 2012
2012 HCPCS A0120
Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems
2012 HCPCS A0110
Non-emergency transportation and bus, intra or inter state carrier
- Added on Sunday, January 01, 1984
- Status changed on Sunday, January 01, 1995 to: No maintenance for this code
- BETOS Classification: Ambulance
- Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
2012 HCPCS A0100
Non-emergency transportation; taxi
- Added on Friday, January 01, 1982
- Status changed on Wednesday, January 01, 2003 to: No maintenance for this code
- BETOS Classification: Ambulance
- Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
2012 HCPCS A0090
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest
- Added on Friday, January 01, 1982
- Status changed on Wednesday, January 01, 2003 to: No maintenance for this code
- BETOS Classification: Ambulance
- Medicare coverage status: Not payable by Medicare (no grace period)
Friday, July 6, 2012
2012 HCPCS A0080
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest
- Added on Friday, January 01, 1982
- Status changed on Wednesday, January 01, 2003 to: No maintenance for this code
- BETOS Classification: Ambulance
- Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
2012 HCPCS A0021
Ambulance service, outside state per mile, transport (medicaid only)
Added on Tuesday, January 01, 1985
Status changed on Tuesday, September 10, 1996 to: No maintenance for this code
See related codes: A0030
BETOS Classification: Ambulance
Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
Added on Tuesday, January 01, 1985
Status changed on Tuesday, September 10, 1996 to: No maintenance for this code
See related codes: A0030
BETOS Classification: Ambulance
Medicare coverage status: Not payable by Medicare (no grace period)
Source - www.icd9data.com
Tuesday, May 1, 2012
HCPCS Level I & Level II Codes
Also pronounced hick-picks, Healthcare Common Procedure Coding System (HCPCS) came into being to provide a standardized coding system. Although these codes were used voluntarily initially, nowadays most organizations include HCPCS codes for electronic transactions.
HCPCS codes are two tiered, referred to as Level I and level II.
HCPCS CPT code: The first level is the CPT coding system, which was developed by American Medical Association (AMA). Level I comprises Current Procedural Terminology (CPT-4) codes and are used for any in-patient or office visits where the treatment or supplies is used in the medical facility.
On the other hand, the second tier is the HCPCS Level II coding which was developed by Centers for Medicare and Medicaid Services (CMS). These codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits. These codes are used for billing ambulance services, prosthetics and other insurance to cover items outside of an office visit.
A brief history of HCPCS coding:
The first level of HCPCS codes came into being way before the 1980s. As new procedures and systems came into being, the second level was created during the early 1980s. The third level of HCPCS codes came into existence in 2003 as new procedures and medical tools were available to localized markets. These codes were developed by both public and private payers on a local level. However, Level III codes are no longer in use these days.
HCPCS code sets and manuals are updated at the start of every calendar year. The changes include coding additions, deletions and replacements.
HCPCS codes are two tiered, referred to as Level I and level II.
HCPCS CPT code: The first level is the CPT coding system, which was developed by American Medical Association (AMA). Level I comprises Current Procedural Terminology (CPT-4) codes and are used for any in-patient or office visits where the treatment or supplies is used in the medical facility.
On the other hand, the second tier is the HCPCS Level II coding which was developed by Centers for Medicare and Medicaid Services (CMS). These codes are also referred to as alpha-numeric codes because they consist of a single alphabetical letter followed by 4 numeric digits. These codes are used for billing ambulance services, prosthetics and other insurance to cover items outside of an office visit.
A brief history of HCPCS coding:
The first level of HCPCS codes came into being way before the 1980s. As new procedures and systems came into being, the second level was created during the early 1980s. The third level of HCPCS codes came into existence in 2003 as new procedures and medical tools were available to localized markets. These codes were developed by both public and private payers on a local level. However, Level III codes are no longer in use these days.
HCPCS code sets and manuals are updated at the start of every calendar year. The changes include coding additions, deletions and replacements.
Monday, April 30, 2012
HCPCS Modifiers Right and Get the Reimbursements You Deserve
Modifiers are certainly important for reimbursement and compliance; if you use them correctly, you can have a positive impact on your reimbursement. Modifiers are two digit codes that modify a service or procedure under certain circumstances. These modifiers may add information or change the description and give more specificity to the service or procedure provided. Append the right modifier and see how your reimbursement heads for the better.
Modifier assignments can be quite intriguing to coders. When trying to understand if a modifier is correct, ask if the following apply:
Was the same service carried out more than once on the same day?
Will a modifier do away the appearance of duplicate billing?
Will the modifier add more information on the anatomic site of the procedure?
If these circumstances apply, then it may be just right to go ahead and append a modifier to the procedure code. Also see to it that the documentation in the medical record supports the use of the modifier.
The modifiers are divided into two levels:
Level I
Level II
The Level II modifiers are called HCPCS modifiers and are annually updated. These HCPCS modifiers are alphanumeric or two letters. Sometimes insurers ask suppliers that a HCPCS code must be accompanied by code modifier to provide added information regarding the service identified by the HCPCS code.
Normally, HCPCS Level II modifiers are required to add specificity to the reporting of procedures carried out on eyelids, fingers, coronary arteries and toes.
Using the HCPCS modifiers the right way will certainly see your reimbursements look up.
Modifier assignments can be quite intriguing to coders. When trying to understand if a modifier is correct, ask if the following apply:
If these circumstances apply, then it may be just right to go ahead and append a modifier to the procedure code. Also see to it that the documentation in the medical record supports the use of the modifier.
The modifiers are divided into two levels:
The Level II modifiers are called HCPCS modifiers and are annually updated. These HCPCS modifiers are alphanumeric or two letters. Sometimes insurers ask suppliers that a HCPCS code must be accompanied by code modifier to provide added information regarding the service identified by the HCPCS code.
Normally, HCPCS Level II modifiers are required to add specificity to the reporting of procedures carried out on eyelids, fingers, coronary arteries and toes.
Using the HCPCS modifiers the right way will certainly see your reimbursements look up.
Friday, April 13, 2012
HCPCS: Q2048, Q2049 Will Stir Your Liposomal Doxorubicin HCL Coding This Summer
CMS would no longer be using J9001 for Doxil once the change happens in July.
One of the side effects of drug shortages is that coders have to determine which HCPCS codes to use for replacement drugs. While deciding how to report two substitution drugs accurately -- Lipodox and Fusilev – you must consider these recent updates from CMS and Noridian Medicare.
Prepare to Use Q2049 This Summer
A shortage of Doxil has led to the temporary importation of a replacement drug, Lipodox. Both Doxil and Lipodox include a doxorubicin hydrochloride liposome injection.
CMS has declared new HCPCS codes for Lipodox and Doxil. The codes will become effective July 1, 2012.
As you can understand from the new codes’ definitions, they differentiate between Doxil and Lipodox:
- Q2048 (Injection, doxorubicin hydrochloride, liposomal, Doxil, 10 mg)
- Q2049 (Injection, doxorubicin hydrochloride, liposomal, imported Lipodox, 10 mg)
To make way for these new HCPCS codes, the July HCPCS update specifies it will revise Doxil’s current code J9001 (Injection, doxorubicin hydrochloride, all lipid formulations, 10 mg) and modify its coverage status to "I." That status means the code is not payable by Medicare (as of July 1).
HCPCS Codes Q2048 and Q2049 both show coverage status "C," demonstrating coverage is at the carrier’s discretion.
Prior to the announcement of the new codes, at least one payer, Noridian Medicare, had instructed its providers to report J9001 for imported Lipodox.
In the payer’s words: Doxil® (J9001) may be replaced with Lipodox® (J9001) which temporarily must be coded as J9001 -- until further notice," as per the March 20, 2012, announcement.
Uses: Physicians may order liposomal doxorubicin HCL to treat ovarian cancer when platinum-based chemotherapy has failed or to treat AIDS-related Kaposi’s sarcoma when chemotherapy has failed. An additional indication is combination with bortezomib (Velcade) to treat multiple myeloma when the patient has received prior therapy other than bortezomib.
Swap J0640 for J0641 for Leucovorin Replacement
Another drug shortage oncology coders have had to face involves leucovorin. The HCPCS codes and agents involved are as follows:
- Leucovorin: J0640 (Injection, leucovorin calcium, per 50 mg)
- Levoleucovorin (Fusilev): J0641 (Injection, levoleucovorin calcium, 0.5 mg)
Noridian spoke of this issue in the same March 20 announcement that discussed Lipodox. The contractor instructed its providers that "Leucovorin (J0640) may be substituted with levoleucovorin (J0641) until such time as the shortage is fixed.
Uses: Before you report either leucovorin or levoleucovorin, ensure that the documentation supports medical necessity. Leucovorin is only required in limited circumstances where folinic acid is required and the patient cannot use regular folate/folic acid. The physician may order it to counteract definite effects of methotrexate or enhance certain effects of 5-fluorouracil.
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