MWilliams01
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Does anyone have the correct HCPCS code for Depo Provera in 2013. Codes J1055 and J1051 have been deleted as of 1/1/13.
OK, I heard back from my clearinghouse they said that the description was not coming through to them for the code? So I called my software guy he had a look at it and after a long discussion we figured out that there was a change made on Jan 1/2013 to the billing method of the J1050. The J1050 must be billed with modifier U1, and is appropriate for the purpose of contraception( as a replacement for the procedure code J1055) This information is directly from the Texas Medicaid Special Blulletin it is called the 2013 HCPCS Special Bulletin. It contains 42 pages and it is packed with a ton of info. So I have resent the claim again with the U1 modifier. I will keep you posted as to what happens.