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J Code Denials

  1. #1
    Default J Code Denials
    Medical Coding Books
    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

  2. Default
    Quote Originally Posted by ILHC View Post
    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
    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-f...3&H1=j1050&M=5

  3. #3
    Default J Code Denials
    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AHCCCS (UHC Community Plan) is denying the J Codes, with an explanation stating "Missing/incomplete/invalid/deactivated/withdrawn National Drug Code"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

  4. Default
    Quote Originally Posted by ILHC View Post
    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AHCCCS (UHC Community Plan) is denying the J Codes, with an explanation stating "Missing/incomplete/invalid/deactivated/withdrawn National Drug Code"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
    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.

  5. #5
    Default J Code Denials
    Thank you so much, I will call the payor to find out.

  6. #6
    Location
    Columbus, Ohio
    Posts
    77
    Default
    You can look up current NDC #'s here to see if they're still valid
    http://www.accessdata.fda.gov/scripts/cder/ndc/

  7. Default 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.

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