Otolaryngology Coding Alert

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You can get paid for albuterol and levalbuterol supply without a hitch if you use a three-tiered approach.

Realize J Codes Are Gone Only for Part B

Although J7611-J7614 are invalid for Medicare, not all insurers may replace J7611-J7614 with Q4093-Q4094. Non-Medicare Part B insurers may still accept the current J codes, says Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.

Why: The AMA has not deleted the J codes, Pohlig says. -Therefore, J7611-J7614 are still fair game for non-Medicare Part B payers.-

Code Inhalation Solution 3 Ways

Until the J codes are deleted from the HCPCS manual, you-ll have to use the payer-preferred supply code. Expect to report albuterol/levalbuterol supply one of three ways:

Method 1: Private payers that never use the HCPCS codes will require 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]).

Method 2: For non-Medicare Part B insurers that continue to accept the J codes, use J7611-J7614.

Method 3: Use Q codes for plans such as Blue Cross and Blue Shield of Minnesota and Blue Plus that implement the albuterol HCPCS level-II code switch immediately.

Find Info Fast With Time-Saving Tips

To determine if your insurer wants the Q codes for albuterol and levalbuterol, try these real-world tips from Rhonda Buckholtz, CPC, administrator at Wolf Creek Medical Associates in Grove City, Pa.:

• Use your private payers- online tools and resources to check the new codes- availability, payment and policies.
• Carefully read all of your Medicaid remits. Medicaid is usually last to make any code changes, which usually appear as a small line item on an RA.
• Sign up for e-mail notices to stay informed of any changes. Example: Buckholtz's Medicare carrier (Highmark Medicare Services) has an e-mail system that alerts her to policy changes and revisions.
• Take time to read your carrier's quarterly report. Glancing at the newsletter up-front will save you from wasting time later resubmitting and appealing denied services, Buckholtz says.