Billing & Coding

You need to have a prescription on file and note the correct modifiers on your claim form stating all conditions have been met (for Medicare). I have had better results attaching the prescription to the claim, however it is not required.

Telehealth Psychiatric Service (Resource 283)

Telehealth (also known as telemedicine) is playing an ever increasing roll in the reimbursement process. Internet services continue to expand and many insurance payers/providers are now covering (paying for) telehealth services. Telepsychiatry (providing behavioral health services in a telehealth environment) has been highly successful because video conferencing makes providing psych services as realitvely simply and inexpensive process.

Effective April 1, 2014, the SI for HCPCS code Q2052 (Services, supplies, and accessories used in the home under the Medicare intravenous immune globulin (IVIG) demonstration) will change:

1)  From SI=N (Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment.)

2) To SI=E (Not paid by Medicare when submitted on outpatient claims (any outpatient bill type)).

Coverage for any DMEPOS items will be considered if the place of service is:

Effective  July 1, 2014 two new HCPCS codes have been created for reporting certain drugs and biologicals and they are effective for services furnished on or after July 1, 2014.

Q9970 - Injection, Ferric Carboxymaltose, 1mg

Q9974 - Injection, Morphine Sulfate, Preservative-Free or Epidural Or Intrathecal Use, 10 mg

 

References:

NEW CODE: G9974 Injection, Morphine Sulfate, Preservative-Free or Epidural Or Intrathecal Use, 10 mg.

  • HCPCS code J2275 (Injection, morphine sulfate (preservative-free sterile solution), per 10 mg) will be replaced with HCPCS code Q9974 effective July 1, 2014.

The SI for HCPCS code J2275 will change to E, “Not Payable by Medicare,” effective July 1, 2014.

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