LMOuellette
Networker
Good Morning everyone, on 1/16 I billed a whole bunch of stress test codes, and they all rejected. They apparently rejected for J0152. Anyone heard anything?
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Wiki J0152
- Thread starter LMOuellette
- Start date
J0152 was deleted. In it's place you'll be using J0151. Watch dosage. J0151 is reported as 1 mg per unit. (the old code was 30 mg per unit)
Jessica CPC, CCC
bportcardio
Guest
Are you having to report the NDC code with your medicaid patients? If so what code are you using. We are finding several different ones and are not sure which is correct. We are working with our vendor but they are just as puzzled at we are.
Sorry, can't help you with your follow up question. We currently don't use this drug.
Jessica CPC, CCC
NDC for J0151
There will be one of several NDC numbers that you will use, depending on the "brand" - either Adenoscan from Astellas or one of the generic suppliers of Adenosine. You can find the NDC number on the vial. Make sure that your Nuclear Techs get the same brand each time from Cardinal or you'll need to change the NDC number when they get a different generic product.
Medicare doesn't usually require the NDC but Medicaid usually does as do many 3rd party payers
There will be one of several NDC numbers that you will use, depending on the "brand" - either Adenoscan from Astellas or one of the generic suppliers of Adenosine. You can find the NDC number on the vial. Make sure that your Nuclear Techs get the same brand each time from Cardinal or you'll need to change the NDC number when they get a different generic product.
Medicare doesn't usually require the NDC but Medicaid usually does as do many 3rd party payers
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alwyzjazzephae
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I had this issue as well but was informed from multiple sources to use A9270. Has anyone else heard to use this as the replacement? 
mitchellde
True Blue
A9270 would not be a replacement for J0151
A9270 is a HCPCS code for a non-covered item or service and should not be used to bill for denial of home infusion items or services. A9270 can only be used if there is no specific HCPCS code for a non-covered item or service and there is no appropriate NOC code available. Per Medicare guidelines, if there is a specific HCPCS for an item or service, then that specific HCPCS should be used. If a denial from Medicare is expected, then the appropriate modifier, GY, GA or GZ should be added to the code. If there is no specific HCPCS code to describe the item, then code A9270 is acceptable.
A9270 is a HCPCS code for a non-covered item or service and should not be used to bill for denial of home infusion items or services. A9270 can only be used if there is no specific HCPCS code for a non-covered item or service and there is no appropriate NOC code available. Per Medicare guidelines, if there is a specific HCPCS for an item or service, then that specific HCPCS should be used. If a denial from Medicare is expected, then the appropriate modifier, GY, GA or GZ should be added to the code. If there is no specific HCPCS code to describe the item, then code A9270 is acceptable.
alwyzjazzephae
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Thank you, I see where I got confused. Also, since the units are changing, then the fee amount billed will also have to be changed as well correct? Would I just divide our current fee for J0152 by thirty?