Internal Medicine Coding Alert

Answer: Since hemocults are common tests done when complete physicals are performed, most payers will probably not pay for the supply separately, says Cindy McMahan, CPC, an independent coding consultant based in Albany, Wis. Health Care Financing Administration (HCFA) guidelines stipulate that the coverage of services and supplies furnished in the office must be determined in accordance with the incident to a physicians professional service provision. Some supplies that are considered incident to a physicians service include the urine dipstick, gloves, gowns, drapes, Band-Aids, minor dressings or other items commonly available for all patients.

Incident to supplies are covered under the overhead reimbursement component of the visit code in the office, according to Medicare policy. Included in these supplies are lidocaine injections used to perform minor procedures. (Lidocaine injected into a joint space may be covered separately.) Surgical trays for some procedures, casting supplies, and parenteral drugs administered in the physicians office are other exceptions to the supplies being covered by the overhead component.

An unspecified supply code of 99070 may be used to bill the hemocult dispenser pak. The CPT descriptor of code 99070 includes supplies and materials provided by the physician over and above those usually included with the office visit or other services rendered. When using code 99070, you must list the description of the supply or service being billed.

Be prepared to submit documentation to support the billing of unspecified supplies. The amount of payment for supplies is calculated at the discretion of the individual payer.