What are HCPCS J codes used for?

What are HCPCS J codes used for?

J-Codes are part of the Healthcare Common Procedure Coding System (HCPCS) Level II set of procedure codes. The codes are used by Medicare and other managed care organizations to identify injectable drugs that ordinarily cannot be self-administered, chemotherapy drugs, and some orally administered drugs.

Does revenue Code 0278 require HCPCS?

A: No. A HCPCS code must be submitted with revenue code 0278 for outpatient claims. If an appropriate HCPCS code is not submitted, the line item will be denied.

Does rev code 0710 require HCPCS?

0710 Revenue Code doesn’t qualify as an allowable code for outpatient facility claims and will be denied. The following revenue codes when billed under OPPS without HCPCS codes are packaged services for which no separate payment is made.

What revenue codes do not require HCPCS?

Revenue code 250 does not require HCPCS coding. However, drugs that can be self-administered are not covered by Medicare.

What year did CMS develop and publish HCPCS?

In 1983 CPT was adopted as part of the Centers for Medicare & Medicaid Services (CMS), formerly Health Care Financing Administration’s (HCFA), Healthcare Common Procedure Coding System (HCPCS). With this adoption, CMS mandated the use of HCPCS to report services for Part B of the Medicare Program.

What is AJ code for Prolia?

Earlier Prolia injection was billed using HCPCS code either J3490 (Unclassified drugs) or J3590 (Unclassified biologics) but effective from January 1, 2012, a new HCPCS procedure code has been assigned to the drug denosumab (Prolia or Xgeva).

Does rev code 270 require HCPCS?

Only the revenue codes listed below are recognized on the outpatient hospital claim as facility revenue codes. Do not list both a facility code and a CPT/HCPCS code. * Revenue code 270 should be reported only once on the outpatient claim. It is to be reported for medical or surgical supplies or both combined.

What is revenue Code 0258?

***Revenue code 0258 requires specific HCPCS when billed on all surgical and medical claims. This revenue code is part of the surgical roll-up for surgical claims. Surgical codes should be submitted on the same claim for the same stay.

What is revenue Code 230?

Separately bill a charge with a recognized routine cost revenue code, such as 230. This allows hospitals to separately bill a line item charge on both inpatients and outpatients. However, note that this particular revenue code is not allowed on outpatient claims.

Does rev code 250 require NDC?

Another use of the 250 revenue code pertains to billing a medication which has a valid HCPCS or CPT code and NDC. In this instance, the medication must be billed with a revenue code, either 250 or 636, along with a valid NDC.

Is HCPCS the same as CPT?

CPT is a code set to describe medical, surgical ,and diagnostic services; HCPCS are codes based on the CPT to provide standardized coding when healthcare is delivered.

Which HCPCS codes are used to identify?

Level II of the HCPCS is a standardized coding system that is used primarily to identify products, supplies, and services not included in the CPT-4 codes, such as ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when used outside a physician’s office.