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What is a GI cocktail and how is it coded?

  1. #1
    Location
    Everett, WA
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    Default What is a GI cocktail and how is it coded?
    Medical Coding Books
    Hello, this coding student would like to know just exactly what IS a GI cocktail, and how is it coded? What is the correct terminology? ---Suzanne

  2. Default
    A GI cocktail is a compbination of medications that is meant to sooth the upper GI tract. It should be coded by the drugs actually used in the cocktail since there are variations, so you would need to seek the advise of the clinical personnel that prepared it.

  3. #3
    Location
    North Carolina
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    Default
    I'm pulling this from memory, but I recall it being lidocaine, donnatel, and maalox. I certainly do remember the awful taste. As for the code, we used 99070; however, it became carrier specific when it came to payment.

  4. #4
    Default
    Many practices are using

    HCPCS- J3490- unclassfied drugs, with and internal description in the practices system billing it out as GI cocktail.

    I recommend using

    HCPCS- J8499- Prescription drug, oral, nonchemotherapeutic, NOS, with your internal system using the description GI cocktail when billing this out.


    Check this site out. It may be of some help.

    http://physicianservices.carilion.co...rner/menu2.htm

    Respectfully
    Daniel, CPC

  5. #5
    Location
    North Carolina
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    Default
    I thought this had been a topic before...I still agree with my original post and current post; although, this is my opinion only.

    http://www.aapc.com/memberarea/forum...ead.php?p=9405

  6. #6
    Location
    Everett, WA
    Posts
    886
    Default F/U to GI cocktail..
    Rebecca and others:
    I had previous followed that older link before submitting the original query and was puzzled by an answer from a member: "For GI cocktail we bill A9150 and 2 units of J8499" Please remember, that I am a student, but one code lists it as a prescription drug, J8499, and the the A9150 lists it as nonprescription, so now what? Thanks for your help! ---Suzanne

  7. #7
    Location
    North Carolina
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    3,126
    Default
    Suzanne,

    I certainly don't want to provide misleading information. As many may already know, I lean towards Medicare guidelines and regs. Many other carriers do tend to follow their guidelines as well. From what I can ascertain, Medicare does not reimburse J8499. It's true, Medicare and others may not reimburse 99070 for a GI cocktail. In my opinion, it really boils down to the guidelines of the specific carrier. It is possible to receive reimbursement with proper documentation and medical necessity. Now...I did find ONE website that instructed to use J8499. I have no idea who they are or how credible they are.
    http://physicianservices.carilion.co...20cocktail.htm

    If I can find something tangible within CMS, that's the lead I take.
    http://www.trailblazerhealth.com/Pub...verageList.pdf

    I can't honestly tell you that there is a definitive answer. I can only provide my personal experience. With this said...I hope others will add their input.

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