Otolaryngology Coding Alert

Replace your albuterol/levalbuterol J codes; delete blood-draw G code Your 2005 superbill updates aren't complete until you add four nebulizer medication codes and remove Medicare's venipuncture code. Each Neb Med Receives Its Own J Code
 
HCPCS 2005 deletes the codes you previously used to report nebulizer medications, J7618-J7619. You should now assign:

  J7611 - Albuterol, inhalation solution, administered through DME, concentrated form, 1 mg
  J7612 - Levalbuterol, inhalation solution, administered through DME, concentrated form, 0.5 mg
  J7613 - Albuterol, inhalation solution, administered through DME, unit dose, 1 mg
  J7614 - Levalbuterol, inhalation solution,  administered through DME, unit dose, 0.5 mg. Benefit: "The new codes make reporting nebulizer medications easier," says P. Lynn Sallings, CPC, a compliance officer in Fayetteville, Ark. You no longer have to lump Albuterol and Levalbuterol together as:
  J7618 - Albuterol, all formulations including separated isomers, inhalation solution administered through DME, concentrated form, per 1 mg (Albuterol) or per 0.5 mg (Levalbuterol)
  or J7619 - Albuterol, all formulations including separated isomers, inhalation solution administered through DME, unit dose, per 1 mg (Albuterol) or per 
0.5 mg (Levalbuterol). "Using the same codes proved confusing because the doses for each medication are different," Sallings says. Tool Makes Assigning J Code a Cinch When coding nebulizer medication, you can now locate the right code using the chart shown at upper right.

Venipuncture Code 36415 Replaces G0001 Your superbill update isn't complete until you delete G0001. HCPCS 2005 deleted G0001 (Routine venipuncture for collection of specimen[s]). "You should use 36415 (Collection of venous blood by venipuncture) instead of G0001," says Mary Falbo, MBA, CPC, president of Millennium Healthcare Consulting Inc., a healthcare consulting firm based in Landsdale, Pa.
  
Deletion reason: CPT code 36415 duplicated temporary HCPCS code G0001. When CPT revised the venipuncture codes in 2003, 36415's revisions made it synonymous with G0001.

HCPCS typically deletes temporary G codes when CPT creates a code that describes the same service. But in this case, HCPCS left G0001, so you had to use G0001 for Medicare and 36415 for all other insurers.

Watch out: Even though you should now report routine venipuncture with 36415 regardless of payer, insurers may bundle the CPT venipuncture code into the claim's E/M service.

Tactic: To avoid denials, append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the E/M code (such as 99201-99215, Office or other outpatient visit for the evaluation and management of a new or established patient ...) if the service is significant and separately identifiable from the blood draw.