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Q0162 verses S0119

  1. #1
    Default Q0162 verses S0119
    Medical Coding Books
    Hello,

    I would like someone to please let me know how to appropriately code for Zofran, when it is given orally to our patients. We received a denial stating Medicare patients need to be coded differently. Non medicare would be S0119, Medicare would be Q0162, correct? In the HCPCS book it says to use this code for Zofran. It also states in the HCPCS description for Q0162: not to exceed 48 hours dosage regimen, for use complete substitute (therapeutic) for an IV at the time of chemo therapy, etc.

    Does this mean i can only use this code for chemo therapy, IV use?! Can someone please let me know?

    Thank you,

    Stephanie Garrison, CPC
    Medical Biller and Coder
    Good Health Financial, PC
    4600 S. Mill Avenue, Ste 280
    Tempe, AZ 85282-6850
    sgarrison@goodhealthfinancial.com

  2. #2
    Location
    Roanoke, Virginia
    Posts
    125
    Default
    I believe Q0162 can ONLY be used when chemotherapy is involved, regardless of the payer. S0119 is the way to go, but I realize only certain payers allow the charge

    Marlena

  3. #3
    Default thanks!
    Hi,

    thanks so much for that response. I now know only some payers with reimburse for S0119.

    Thank you,

    Stephanie Garrison, CPC
    Medical Biller and Coder
    Good Health Financial, PC
    4600 S. Mill Avenue, Ste 280
    Tempe, AZ 85282-6850
    sgarrison@goodhealthfinancial.com

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