Wiki New HCPCS Code J1010 Denials

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mckenzieehrhard

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Since HCPCS codes J1020, J1030, and J1040 have been deleted as of 3/31/24 and J1010 is now the effective code as of 4/1/24 for Depo-Medrol injections, our practice has received denials on every claim we have submitted to insurance stating the code is invalid. Is anyone else coming across this issue?
 
Anthem is paying it for us, they are the only ones that I know of so far. Most payers are rejecting through our clearinghouse and won't even accept the claim to process it. Very frustrating!
 
I would suggest a possible claims hold at the provider level for a period of time until they get their systems updated.
Otherwise, you would want to have a really good tracking method for these.
Is the performance of the injection being denied too or just the drug? Does it have the correct NDC #s?
 
mckenzieehrhard said:
Since HCPCS codes J1020, J1030, and J1040 have been deleted as of 3/31/24 and J1010 is now the effective code as of 4/1/24 for Depo-Medrol injections, our practice has received denials on every claim we have submitted to insurance stating the code is invalid. Is anyone else coming across this issue?
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YES WE ARE HAVINGTHIS CODE DENIED BY ALL COMMERCIAL PAYERS HAVE NOT HEARD A THING FROM MEDICARE
 
mckenzieehrhard said:
Since HCPCS codes J1020, J1030, and J1040 have been deleted as of 3/31/24 and J1010 is now the effective code as of 4/1/24 for Depo-Medrol injections, our practice has received denials on every claim we have submitted to insurance stating the code is invalid. Is anyone else coming across this issue?
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HAVE YOU FOUND THIS ON THE MEDICARE WEBSITE IF SO WHERE I CANNOT FIND ANYTHING RELATED TO THIS CODE ?
 
JGILBERT1 said:
HAVE YOU FOUND THIS ON THE MEDICARE WEBSITE IF SO WHERE I CANNOT FIND ANYTHING RELATED TO THIS CODE ?
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It was like finding a needle in a haystack. It was in the 4th Quarter 2023 HCPCS coding Cycle letter from CMS and it is on page 34 (the very last page) it shows J1020,30,40 deleted and J1010 1 mg as the new code.
 
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