As an orthopaedic practice, we do a lot of steroid injections in the office. We also, see a lot of Pennsylvania workers' compensation.
does anyone else bill work comp claims? If so, how are you billing the J-codes?
When we bill J0702 the ndc code is listed as part of the description on the Hcfa, does anything else need to be on the HCFA?
The reason I am reaching out, is because some of the insurance carriers, have not been paying the meds on our claims. I recently read the following and I am wondering is this the
reason:
All J codes have been removed from the Part B fee schedule , which state payments are paid at 110% of the AWP. Because J code reimbursement is not calculated this way, it is incorrect to use these codes for billing or reimbursement of PA Workers" Comp. Drugs and pharmaceuticals previously billed with J codes should be billed or downcoded to a valid NDC associated with an AWP and reimbursed.
Thank you in advance for your help!
does anyone else bill work comp claims? If so, how are you billing the J-codes?
When we bill J0702 the ndc code is listed as part of the description on the Hcfa, does anything else need to be on the HCFA?
The reason I am reaching out, is because some of the insurance carriers, have not been paying the meds on our claims. I recently read the following and I am wondering is this the
reason:
All J codes have been removed from the Part B fee schedule , which state payments are paid at 110% of the AWP. Because J code reimbursement is not calculated this way, it is incorrect to use these codes for billing or reimbursement of PA Workers" Comp. Drugs and pharmaceuticals previously billed with J codes should be billed or downcoded to a valid NDC associated with an AWP and reimbursed.
Thank you in advance for your help!