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Coding vs Billing question

  1. #1
    Greater Atlanta
    Default Coding vs Billing question
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    This is a question from an HIM standpoint, not a billing standpoint. We have patients receiving Immunoglobulin IVIG in our hospital outpatient setting. We have a coding department and a separate billing department. We do have Medicare patients and private payors and that coding needs to be consistent across payors.
    In coding these, we use the infusion code 96365 and along with it, the CPT medicine code, 90283. However, Medicare doesn't accept the 90283 and wants a J code. In your facilities, who's responsibilty is it to assign the J code? Is it HIM/coding or the billing department? Normally, HIM in this setting doesn't have much to do with HCPCS codes.

    Anybody out there had this discussion? We are curious to see what others are doing. Thanks for any input you may have.
    Inpt & Outpt Coder

  2. #2
    Phoenix, AZ
    At a previous employer, it was coding responsibility to assign J codes.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3
    At our facility it is the responsibility of the coding department to assign J codes. I am the coder for our infusion center and I am responsible for assigning J codes.

  4. #4
    Greater Atlanta
    So, to follow up on that question, when you code with the J code, do you also include the 90283 at the same time? Part of our concern in HIM is not coding all the payors consistently the same, and the question comes in, should we include 90283 on all the accounts for data retrieval purposes as well as for billing?
    Inpt & Outpt Coder

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