Part B Insider (Multispecialty) Coding Alert

Published on Thu Oct 18, 2007 PDF

And HCPCS now includes Supprelin LA code

Hot on the heels of the new CPT 2008 introduction, you-ve got more new codes to assign to your claims with the introduction of several HCPCS codes effective Jan. 1. Here's how the new codes break down by specialty:

Ophthalmology: The big news for ophthalmology coders is that you now have a code to report Lucentis (J2778). Gone will be the days of using unclassified codes J3490 (Unclassified drugs) or J3590 (Unclassified biologics) for this drug.

Oncology: HCPCS deletes previous panitumumab code C9235 and debuts new code J9303 (Panitumumab injection, 10 mg). -Panitumumab is a very useful drug and will be used a lot,- says Barbara L. McAneny, MD, CEO of New Mexico Oncology Hematology Consultants Ltd. in Albequerque. -When drugs are new, they get average wholesale priced for a while, so CMS likes to get them specific codes ASAP. That hurts us in price, but forces private payers to acknowledge the drug as standard of care.-

Endocrinology: If you were frustrated with the lack of specificity when reporting Supprelin LA, you-ll be able to abandon J3490 in favor of new code J9226 (Histrelin implant, Supprelin LA, 50 mg).

Urology: Because HCPCS introduced J9226, the existing histrelin implant code (J9225) will now have a new descriptor indicating that it specifically refers to Vantas.

Skin substitutes: In addition, HCPCS will make skin substitute coding easier with the debut of J7347 (Integra matrix), J7348 (Tissuemend) and J7349 (Primatrix). 

-It's nice to have specific codes to attach to specific products,- says Linda Martien, CPC, CPC-H, of National Healing Corporation. -It's often more of a challenge to select the correct application codes, especially when coders don't understand the difference between allograft, xenograft, metabolically active, non-metabolically active, etc.-

Gastroenterology: You-ll also gain specificity when coding claims for G-tube and J-tube equipment. HCPCS deletes B4086, which covered claims for both standard- or low-profile tubes. In its place, you-ll be able to choose from B4087 (for standard tubes) and B4088 (low-profile tubes).

What's not there: If you were looking for a code to replace J3490 for Cardizem, Tiazac, sodium bicarbonate or Tensilon, you-re not in luck this year.