Otolaryngology Coding Alert

You-re going to code rescue med supply based on drug -- again If you flagged J7611-J7614 as invalid for CMS, you can green light the codes with a "valid as of April 1, 2008" notation. The spring-quarter updates to HCPCS 2008 delete albuterol/levalbuterol codes J7602 (Albuterol, all formulations including separated isomers, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, per 1 mg [albuterol] or per 0.5 mg [levalbuterol]) and J7603 (- unit dose ...). Effective April 1, HCPCS reinstates: - J7611 -- Albuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, 1 mg - J7612 -- Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, 0.5 mg - J7613 -- Albuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose, 1 mg - J7614 -- Levalbuterol, inhalation solution, FDA-approved final product, noncompounded, administered through DME, unit dose, 0.5 mg. The swap: In March, "We were using J7603 for albuterol," says Diane Nelson, RTR, CPC, medical coder for Vanguard Medical Services in Frederick, Md. In April, "We changed back to J7613." The CMS fee schedule Web site recognizes J7611-J7614 and not J7602-J7603. Switch Back to Drug-Specific Codes You may recall that last July, CMS replaced J7611-J7614 with Q4093 (Albuterol, all formulations including separated isomers, inhalation solution, FDA-approved final product, noncompounded, administered through DME, concentrated form, per 1 mg [albuterol] or per 0.5 mg [levalbuterol]) and Q4094 (- unit dose ...) "Both Q4093 and Q4094 were deleted effective Jan. 1, 2008," says Jay Neal, a coding consultant in Atlanta. "HCPCS introduced new albuterol-levalbuterol combination codes J7602-J7603 to take the place of those deleted Q codes for 2008." Medicare decided it was better to use the four codes that separated albuterol from levalbuterol, rather than the combined drug codes J7602-J7603. Focus on 2 J7611-J7614 Factors You can get the correct noncompounded solution supply code if you zoom in on two items: - form -- concentrated (J7611, J7612) or unit dose (J7613, J7614). - drug -- albuterol (J7611, J7613) or levalbuterol (J7612, J7614).