Pulmonology Coding Alert

On the Cutting Edge:

Use 2 Questions to Pin Down J7611-J7614 Inhalation Coding

You can crosswalk brands, deleted code with this flowchartA year and a half has passed since you stopped using the codes for drug-specific noncompounded inhalation solutions, meaning you're going to need a refresher to start reusing this system.Start using J7611-J7614 for all payers, says Denae M. Merrill, CPC-E/M, owner of Merrill Medical Management in Saginaw, Mich. Appeal or adjust the codes as needed if insurers reject them.Private payers seem to be following Medicare's lead, Merrill says. "Several Blue Cross Blue Shield companies, as well as Aetna, are back to accepting the J7611-J7614 codes."For payers that are slow to implement the drug-specific J codes from 2007, remind them that HIPAA requires all insurers to recognize the national coding system, which includes the spring updates to the HCPCS supply codes.Action: Nudge insurers to update their systems when you appeal by including the explanation that CMS reinstated J7611-J7614 in lieu of J7602-J7603, effective April 1, 2008. Include a copy of the MLN Matters article available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5981.pdf or the transmittal from http://www.cms.hhs.gov/transmittals/downloads/R1492CP.pdf.Speed tip: To get the correct J7611-J7614, answer these questions using this flowchart and key words:ICD-9 2009 Update:
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 Revenue Cycle Insider
  • 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