Primary Care Coding Alert

Question: We're receiving denials when we report codes J7610 and J0570. Can you advise regarding what the problem might be?

Tennessee Subscriber

Answer: Code J0570 (Injection, penicillin G benzathine, up to 1,200,000 units) was deleted on January 1, 2011. It crosswalks to new code J0561 (Injection, penicillin G benzathine, 100,000 units), which you should report instead.

Code J7610 (Albuterol, inhalation solution, compound product, administered through DME, concentrated form 1 mg) is still an active code, but Medicare coverage and payment is at the judgment of the Medicare contractor.

Best bet: Contact your Medicare contractor or other payer to determine whether it will pay for J7610 and, if so, under what conditions.