• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Zoladex. Lupron and Eligard

Create Wiki
D

dsmith03@hotmail.com

Guest
Messages
19
Best answers
0
Ok Urology Coders, need some help. I am fairly new to coding. My coworker has been in the office for 40 years, but is not certified. She keeps telling me that we can't give a patient Lupron unless they are grandfathered in (medicare). What does this mean? And where is it documented?

So most of our patients are on Zoladex. We have one patient that can't tolerate Zoladex and have switched him to Eligard. Eligard and Lupron use the same HCPCS code J9217. Will we run into the grandfathered in clause in switching the patient to Eligard?
 
We administer Eligard, Lupron, Zoladex and Trelstar to our Medicare patients. I have never had a problem billing and getting reimbursed on any one of them in 6 years.
 
Agreed we bill Lupron 1mo or 3mo J9217 and admin 96402 and get reimbursed Jurisdiction E Part B
 
You must log in or register to reply here.
Top