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Hcpcs code j1071

  1. #1
    Location
    Louisville Kentucky
    Posts
    4
    Default Hcpcs code j1071
    Medical Coding Books
    When reviewing this new code; which replaces HCPCS codes J1070 (up to 100mg) and J1080 (200mg), we realized that the new code j1071 is only 1mg. The 2015 HCPSC book doesn't give any details on how to code for multiple mg. I want to say that we would bill for how many mg used (ex: 50mg given charge for x50), but I don't want to assume without confirmation.

    Has anyone ran across this yet?

    Ruby

  2. #2
    Location
    Dover Seacoast New Hampshire
    Posts
    2,030
    Default
    If your billable unit is 1 mg (as in this case) and you administer 200 mg, then you're going to bill 200 units.

    HCPCS doesn't publish specific billing rules regarding units, mostly because the units reported in HCPCS may or may not be the typical administered dosage, or may not be the dosage available in your geographical area. That's why you have to adjust the code based on the administered units.
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. Default J1071
    We ran across this issue @ our office. I found out thru phone call to cahaba that this new code was not included in the 2015 fee schedule and that until it was on the fee schedule they could not give us any information on the code. We feel like it is an error. I personally do not believe a claim w/ 200 units would be paid. We are holding our claims for this injection until we have more info. Have you found out anything new?

  4. Default
    J1080 is not even listed in the set of new/revised/deleted codes??? This makes me wonder if there has been an error.

  5. Default galactallent
    Unfortunately, claims we have filed using J1071 since January 01, 2015 have been denied. Rejection states "HCPCS Procedure Code is invalid in Professional Service. Value of element is incorrect" Any help would certainly be appreciated.

  6. Unhappy frustrated
    Code J1080 is not even passing the clearing house as a valid code, so if all of this is true, none of the codes are being accepted.

  7. Default CPT code J1070
    Has anyone successfully billed with this code yet, I have multiple claims I need to resend before I hit timely filling. J1070 and J1080 have definitely been deleted but I just can't imagine billing 100 units and 200 units for a code and getting paid.

  8. #8
    Location
    Cadillac, MI
    Posts
    22
    Smile J1071
    I bill out the J1071 with 200 units and all of our claims get paid. Not sure what the issue is.
    Shelly Mumah, CPC, COBGC, RH-CBS

  9. #9
    Default # units billed with J1071
    Shelley M,

    We have been billing (1) unit of J1071 as our billing software pulls the description up as Testosterone Ciponate 200mg/mL. Reimbursement is around $.03, which is ludicrous. May I please ask what you are seeing in terms of a reimbursement range with billing (200) units of J1071?

    Also speaking to the J1080 concerns---our software rejects this code even before it gets to the clearing house stating it is no longer a valid code and that J1071 is to be used instead.

    HELP!!

    Thanks in advance,
    Melissa

  10. Default
    You were paid for 1mg because you billed one unit instead of the number of units administered. You can find the amount paid by Medicare for any covered medication at https://www.cms.gov/Medicare/Medicar...5ASPFiles.html. The October pricing file shows code J1071 is paid per 1 mg at .027 cents per unit. Hope that helps.

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