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Thread: HCPCS Help needed!!

  1. #1
    Join Date
    Apr 2007
    Murrieta, CA

    Question HCPCS Help needed!!

    AAPC: Back to School
    I am looking for HCPCS codes for the following medications that our doctors dispense to the patients and we bill to their WC carriers.

    Ketoprofen / Orudis - 75mgs
    Prilosec / Omeprazole - 20mgs
    Paxil / Paroxetine - 10mgs and 20mgs
    Ibuprofen / Motrin - 600mgs & 800mgs
    Hydrocodone / Norco - 10/325mgs
    Ambien / Zolpidem - 10mgs
    Neurontin / Gabapentin - 600mgs
    Naproxen / Anaprox - 550mgs
    Zoloft / Sertaline - 25mgs
    Ceclor / Cefaclor

    I've searched my 2010 HCPCS books and the internet and I'm not finding anything for these meds. I have to use the HCPCS codes to bill them to the work comp carriers since they are dispensed in office.

    Thanks for you help!

    Deedee Fronius, CPC
    Workmans Compensation Coder/Collector
    Garfield Health Center Medical Group
    320 S. Garfield Ave. Suite 322
    Alhambra, CA 91801

  2. #2
    Join Date
    Apr 2007


    Didn't think oral meds were billable. None of these drugs are in 2009 HCPCS either.

  3. #3
    Join Date
    Apr 2007
    Murrieta, CA


    They are billable but we have been using 99070- Unlisted or Misc. supply with the NDC number for the medications. I'm getting denials stating "As of 1/1/2004 all supplies must have the corresponding HCPCS code for proper reimbursement." Sometimes we get paid for the 99070 code, some times we don't because of this stupid law! I'm wondering if there is a misc oral code that we can use?

  4. #4


    wouldn't those be Z or X codes for formulary drugs? Miscellaneous drugs for non-surgical use?
    I'm not sure those codes are even in a HCPCS book, but they have to be listed someplace.

  5. #5
    Join Date
    Apr 2007
    Charm City


    I think you might need to fight with the company who is denying because there are no HCPCS codes for oral medications. I couldn't find a code to represent misc oral medications either. Let us know how this turns out!

  6. #6


    J8499 with a side note of the name and dosage of the oral med is what we use

  7. #7
    Join Date
    Apr 2007


    Odd place to put misc oral drugs, right after inhalation drugs but right before oral chemotherapy medications.

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