Wiki J Code Denials

Create Wiki
I

ILHC

Contributor
Messages
22
Best answers
0
Hello,

I was hoping someone could provide some guidance. We have been getting denials on the following J Codes
J2250
J1080
J1050
and I wanted to know if we should be billing a modifier with these codes?

Please Help

Thanks
 
ILHC said:
Hello,

I was hoping someone could provide some guidance. We have been getting denials on the following J Codes
J2250
J1080
J1050
and I wanted to know if we should be billing a modifier with these codes?

Please Help

Thanks
Click to expand...

What does the denial code say? If it's medicare, they are most likely non-priced, bundled or N status codes. I'm not sure what modifier you think you would need?

You can check the fee schedule at:

https://www.cms.gov/apps/physician-...h-results.aspx?Y=0&T=4&HT=0&CT=3&H1=j1050&M=5
 
Hello,

AHCCCS (UHC Community Plan) is denying the J Codes, with an explanation stating "Missing/incomplete/invalid/deactivated/withdrawn National Drug Code"

Does this mean that they are not paying for these codes?

Thanks
 
ILHC said:
Hello,

AHCCCS (UHC Community Plan) is denying the J Codes, with an explanation stating "Missing/incomplete/invalid/deactivated/withdrawn National Drug Code"

Does this mean that they are not paying for these codes?

Thanks
Click to expand...

It sounds like the code used was replaced. make sure the code is a current code, NDC number. You may have to call the payor for more info.
 
Ndc#

you must have attached to your claim the NDC#, units and measures for your claim to pay. Watch out some payers are also asking for office notes.
 
You must log in or register to reply here.
Top