Advanced Search

Cardiology Coding Alert

READER QUESTIONS:

WC Fee Schedule May Be Out of Date

Published on Sat Sep 26, 2009

Question: I had to send claims to another state's workers' compensation program, and I received a denial for LOCM (Omnipaque 300) using Q9967. Which code should I use? Nebraska Subscriber Answer: You'll need to check that state's workers' compensation (WC) fee schedule. Many programs update their fee schedule only once every few years, and the low osmolar contrast (LOCM) codes have changed several times in recent years. For the concentration you used, HCPCS 2009 shows Q9967 (Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml), which went into effect in 2007. The payer may want you to use Q9949 (Low osmolar contrast material, 300-349 mg/ml iodine concentration, per ml), which went into effect in 2005. Some coders report their programs request codes from even longer ago, such as A4646 (Supply of low osmolar contrast material 300-399 mg of iodine). Keep in mind: The "standardized transactions and code sets" [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Cardiology Coding Alert

View All