Pulmonology Coding Alert
Use 2 Questions to Pin Down J7611-J7614 Inhalation Coding
You can crosswalk brands, deleted code with this flowchart 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: ICD-9 2009 Update:
Pulmonology Coding Alert
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