J-codes when bill Pennsylvania Workers comp


Best answers
As an orthopaedic practice, we do a lot of steroid injections in the office. We also, see a lot of Pennsylvania workers' compensation.
does anyone else bill work comp claims? If so, how are you billing the J-codes?
When we bill J0702 the ndc code is listed as part of the description on the Hcfa, does anything else need to be on the HCFA?
The reason I am reaching out, is because some of the insurance carriers, have not been paying the meds on our claims. I recently read the following and I am wondering is this the

All J codes have been removed from the Part B fee schedule , which state payments are paid at 110% of the AWP. Because J code reimbursement is not calculated this way, it is incorrect to use these codes for billing or reimbursement of PA Workers" Comp. Drugs and pharmaceuticals previously billed with J codes should be billed or downcoded to a valid NDC associated with an AWP and reimbursed.
Thank you in advance for your help!


True Blue
Clovis, CA
Best answers
The specific denial information might be helpful. What that information looks like is, the AWP will be used for pricing and not a specific fee schedule. I'm wondering if they want 99070 with the NDC code instead of the Jcode.