Page 2 of 3 FirstFirst 123 LastLast
Results 11 to 20 of 24

Thread: Depo Provera

  1. #11
    Join Date
    Apr 2007
    Location
    Albany, New York
    Posts
    456

    Default

    If you do a Forum Search for J1050, there are 2 other threads where this
    issue is being discussed.
    Karen Maloney, CPC
    Data Quality Specialist

  2. #12

    Default Depo Provera J1055

    I question whether we should be using the J1050 as this represents 1mg/ml and may have a different NDC# vs the old J1055 which was 150mg/ml -
    Nobody seems to have a good answer as how to bill this appropriately. Checked with Cigna and Aetna and couldn't get an answer here in Maine.

  3. #13
    Join Date
    Apr 2007
    Posts
    10

    Default

    We used CPT J1050 with 150 units using a dx 625.3 on a CGS Medicare patient. The claim was processed just fine with an allowed amount on the J1050 of $30 to deduct. Fingers crossed that we have no problems with other payers!

  4. #14
    Join Date
    Apr 2007
    Posts
    22

    Default

    You said you needed to use a modifier, are you applying the U1 on the claim line item J1050? The reason I ask, I was told to add the U1 to the end of my NDC# in the appropreate field on my claim. After reading your message now I'm not sure which place to apply the U1. Please clairify where you applied the U1.
    Or was the U1 added by your sofeware IT agency?

    Sorry for the confusion just wanna get it straight.
    Thank you,
    LB

  5. #15

    Default

    I am in Washington state, does the U1 modifier not apply to us?

  6. #16

    Default j1055

    Have called AAPC, AMA, NHIC (which the AMA told me to contact as they handle the HCPCs supposedly) and have got no where. It's like no one understands the dilemma that J1050 does not in any way shape or form equate J1055 without fudging the info i.e. NDC# but am still pursuing as I am tenacious to get to the bottom of what I think is an error in the HCPCs on someones part.

  7. #17

    Default

    Does anyone know in the state of WA if we need to use a modifier for the new depo code? I have been billing the J1050 with 150 units, but was informed some payors will not pay with that many units, it's confusing to me...

  8. #18

    Default

    Thanks for the info. i will be watching closely to see what happens with payment from MCD. On another related subject, would anyone know what cpt codes to use for well woman annual gynecological exams for medicare? Medicare does not use 99384-87, or99394-97 preventive med. E&M codes. My predecessor used a regular E&M code as the visits are almost always comprehensive and involve a multitude of gyne complaints, that go well beyond a v72.31 DX code and pap smear. The major problem with this is that annual exams are exempt from deductible and co-pays, and a regular E&M code will not recognize this. Also, have they bundled the pap smear into the annual, so it is now unnecessary to keep track every 2 years for billing? Could someone give me an example of a cpt and dx coding for medicare annual exam?

  9. #19

    Default Depo & Annual Gyne exam

    Thanks for the info. i will be watching closely to see what happens with payment from MCD. On another related subject, would anyone know what cpt codes to use for well woman annual gynecological exams for medicare? Medicare does not use 99384-87, or99394-97 preventive med. E&M codes. My predecessor used a regular E&M code as the visits are almost always comprehensive and involve a multitude of gyne complaints, that go well beyond a v72.31 DX code and pap smear. The major problem with this is that annual exams are exempt from deductible and co-pays, and a regular E&M code will not recognize this. Also, have they bundled the pap smear into the annual, so it is now unnecessary to keep track every 2 years for billing? Could someone give me an example of a cpt and dx coding for medicare annual exam?

  10. #20
    Join Date
    Apr 2007
    Posts
    16

    Default Depo reimbursement

    2017 ICD-10-CM Coding Book
    I was just wondering if any of you are experiencing lower reimbursement for Medicaid and BC/BS patients when they receive Depo Provera, we have been billing J1050 with 150 units and are reimbursement this year doesn't even cover the cost of the drug we are losing money. Are any of you experiencing the same thing and if so how are you handling this to offset your costs now? It was suggested charging nurse visits when they come in for the Depo shots, having the nurse document vitals and giving information to the patient regarding the drug. I am not really comfortable doing this as I really don't feel its appropriate, but the doctors don't want to stop giving the Depo either. Thank you for your help.

Page 2 of 3 FirstFirst 123 LastLast

Similar Threads

  1. Depo Provera
    By marygask in forum OB/GYN
    Replies: 2
    Last Post: 05-14-2013, 11:20 AM
  2. Depo-Provera
    By TYSON1234 in forum OB/GYN
    Replies: 1
    Last Post: 04-19-2013, 02:56 PM
  3. New code for Depo-Provera??
    By mrockvoan in forum Family Practice
    Replies: 5
    Last Post: 03-18-2013, 01:25 PM
  4. Depo Provera administration
    By soprano in forum Family Practice
    Replies: 3
    Last Post: 10-26-2010, 09:28 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.