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Worker's Comp Billing

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  • SDAmom2@aol.com
    Hi Everyone, I just received a phone call from a doctor that may possibly want me to do their worker s comp billing, but how do you know what to charge? Would
    Message 1 of 15 , Oct 26, 2006
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      Hi Everyone,

      I just received a phone call from a doctor that may possibly want me to do
      their worker's comp billing, but how do you know what to charge? Would I charge
      per claim, percent, or flat rate? Any ideas would be appreciated. My only
      dilemna is that I have never done WC billing, so because of that should I pass
      on this possible client? Any suggestions?

      Donna
      www.wekarebillingservice.com


      [Non-text portions of this message have been removed]
    • Tanya Peck
      ... me to do ... Would I charge ... My only ... should I pass ... In my opinion, WC billing is just like any other insurance. You simply have to make sure to
      Message 2 of 15 , Oct 26, 2006
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        --- In MedicalBillers@yahoogroups.com, SDAmom2@... wrote:
        >
        > Hi Everyone,
        >
        > I just received a phone call from a doctor that may possibly want
        me to do
        > their worker's comp billing, but how do you know what to charge?
        Would I charge
        > per claim, percent, or flat rate? Any ideas would be appreciated.
        My only
        > dilemna is that I have never done WC billing, so because of that
        should I pass
        > on this possible client? Any suggestions?
        >
        > Donna
        > www.wekarebillingservice.com

        In my opinion, WC billing is just like any other insurance. You
        simply have to make sure to attach a copy of the office visit notes
        to the claim, once it's already been reported. It's the first visit
        that might be a little bit more detailed, as there is a form that the
        patient and doctor have to fill out, then you mail a copy to the
        employer, the state, and the insurance company with the first claim
        (along with the notes) At least, this is how it works in Arizona.

        I would charge him just as I would any other client, which is by
        percentage (that's how I charge) and would not consider
        him "different" then from other clients.

        Hope that helps!

        Tanya Peck
        www.PecksMedicalBilling.com

        >
        >
        > [Non-text portions of this message have been removed]
        >
      • J. Scott Gleaton
        Medical billing is all the same. The only differences are in globals etc., which are, for the most part, per insurance company. I would SOOOOOO much like to
        Message 3 of 15 , Oct 26, 2006
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          Medical billing is all the same. The only differences are in globals etc., which are, for the most part, per insurance company. I would SOOOOOO much like to get into something like that.

          If you know of any doctor that has a need for a medical biller, be it W/C, hospital, or otherwise; please have them contact me!

          Scott Gleaton

          SDAmom2@... wrote:
          Hi Everyone,

          I just received a phone call from a doctor that may possibly want me to do
          their worker's comp billing, but how do you know what to charge? Would I charge
          per claim, percent, or flat rate? Any ideas would be appreciated. My only
          dilemna is that I have never done WC billing, so because of that should I pass
          on this possible client? Any suggestions?

          Donna
          www.wekarebillingservice.com

          [Non-text portions of this message have been removed]







          10515 US Hwy 431
          LaFayette AL 36862-5421
          Telephone: (334) 559-6946
          Moderator: Yahoo Group ALMT

          As for me and my house
          __[] _____
          ¸...¸ /____ /\____\__
          ,·´º o`·,/__/ _/\____\ __\
          ```)¨(´´´ | | | | | | | || |l±±±±
          ¸,.-·²°´ ¸,.-·~·~·-.,¸ `°²·-. :º°
          We will serve the Lord.


          [Non-text portions of this message have been removed]
        • s_alyssandra
          Hello Donna! This is Pinky again! --- I have been handling and billing WC / No Fault cases for the last 8 years and I love it! As what the other members said,
          Message 4 of 15 , Oct 27, 2006
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            Hello Donna!

            This is Pinky again! --- I have been handling and billing WC / No Fault
            cases for the last 8 years and I love it!

            As what the other members said, you charge them the same. But you have
            to make sure you attach the medical/progress notes on the claim. For
            procedures, you attach all necessary medical documents too! Precerts/RX
            etc.

            Here is my advise, get the adjustor's name. I always work closely with
            the adjustor! To make sure your claims goes to the right place. And whom
            to contact directly regarding the claims.

            In my experience, I never had denied or rejected claims for WC/No Fault.

            Here is the good news Donna!--- I know that WC/No Fault pays more
            compared to other insurances. So you get paid with these kind of claims.

            I hope this helps. Please email me if you need additional help at
            ms.pinky@... <mailto:ms.pinky@...>

            Regards!

            Pinky

            www.justmypassion.com <http://www.justmypassion.com>


            --- In MedicalBillers@yahoogroups.com, "J. Scott Gleaton"
            <alcowboy03@...> wrote:
            >
            > Medical billing is all the same. The only differences are in globals
            etc., which are, for the most part, per insurance company. I would
            SOOOOOO much like to get into something like that.
            >
            > If you know of any doctor that has a need for a medical biller, be it
            W/C, hospital, or otherwise; please have them contact me!
            >
            > Scott Gleaton
            >
            > SDAmom2@... wrote:
            > Hi Everyone,
            >
            > I just received a phone call from a doctor that may possibly want me
            to do
            > their worker's comp billing, but how do you know what to charge? Would
            I charge
            > per claim, percent, or flat rate? Any ideas would be appreciated. My
            only
            > dilemna is that I have never done WC billing, so because of that
            should I pass
            > on this possible client? Any suggestions?
            >
            > Donna
            > www.wekarebillingservice.com
            >
            > [Non-text portions of this message have been removed]
            >
            >
            >
            >
            >
            >
            >
            > 10515 US Hwy 431
            > LaFayette AL 36862-5421
            > Telephone: (334) 559-6946
            > Moderator: Yahoo Group ALMT
            >
            > As for me and my house
            > __[] _____
            > ¸...¸ /____ /\____\__
            > ,·´º o`·,/__/ _/\____\ __\
            > ```)¨(´´´ | | | | | | | || |l±±±±
            > ¸,.-·²°´ ¸,.-·~·~·-.,¸ `°²·-. :º°
            > We will serve the Lord.
            >
            >
            > [Non-text portions of this message have been removed]
            >




            [Non-text portions of this message have been removed]
          • blanche2talk
            ... me to do ... Would I charge ... appreciated. My only ... should I pass ... PERSON BECAUSE I JUST FINISHED CONTRACTING WITH A BIG CONTRACT AT 8 PERCENT I
            Message 5 of 15 , Oct 27, 2006
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              --- In MedicalBillers@yahoogroups.com, SDAmom2@... wrote:
              >
              > Hi Everyone,
              >
              > I just received a phone call from a doctor that may possibly want
              me to do
              > their worker's comp billing, but how do you know what to charge?
              Would I charge
              > per claim, percent, or flat rate? Any ideas would be
              appreciated. My only
              > dilemna is that I have never done WC billing, so because of that
              should I pass
              > on this possible client? Any suggestions?
              >
              > Donna
              > www.wekarebillingservice.com
              >
              >
              > [Non-text portions of this message have been removed]
              >YES I HAVE A BILLING COMPANY AND I KID YOU NOT IT DEPENDS ON THE
              PERSON BECAUSE I JUST FINISHED CONTRACTING WITH A BIG CONTRACT AT 8
              PERCENT I AM BLESSED WITH THIS GOOD LUCK IN THE JOB YOU KNOW I
              STARTED WITH 6 PERCENT BUT I KNOW I COULD OF STARTED BIG YOU GO
              SMALL AND BUILD CONFIDENCE AND THEN YOU CAN ASK YOUR PRICE
            • djgeisel
              Work Comp is a little more complicated than regular insurance, in my humble opinion. First in our state Texas work comp just went with networks and that
              Message 6 of 15 , Oct 30, 2006
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                Work Comp is a little more complicated than regular insurance, in my
                humble opinion. First in our state Texas work comp just went with
                networks and that complicates things a bit, but if you just remember
                that the rules are set by the network you should be OK if yu ask the
                right questions. Be sure you have a compensable injury and that the
                procerdures done, office notes, diagnosis, all match up with the
                injury reported. I say that because so often a patient reports one
                thing to the employer and when they see the doc they may realize
                there is more than one issue. The doc treats say 2 issues then and
                he can't get paid. Why? All the paperwork did not match up. I try
                to get a copy of the first report of injury from the patient. They
                are entitled to it. Then if they say more to the doc, they either
                have to go back and correct it with the employer, or you just don't
                bill that part that was not reported to the employer. Also some
                services will need pre-cert be sure that is done if needed. I am not
                only a biler but office manager and maybe when you are with a billing
                service all those other issues are not part of your concern... but
                they are mine. Best of luck! Diana
                --- In MedicalBillers@yahoogroups.com, SDAmom2@... wrote:
                >
                > Hi Everyone,
                >
                > I just received a phone call from a doctor that may possibly want
                me to do
                > their worker's comp billing, but how do you know what to charge?
                Would I charge
                > per claim, percent, or flat rate? Any ideas would be appreciated.
                My only
                > dilemna is that I have never done WC billing, so because of that
                should I pass
                > on this possible client? Any suggestions?
                >
                > Donna
                > www.wekarebillingservice.com
                >
                >
                > [Non-text portions of this message have been removed]
                >
              • Joktan Edison
                Does Medicare pays for J3490 codes by any chance? If they don t pay what is that we have to do inorder to get paid. I would appreciate your thoughts. Contact
                Message 7 of 15 , Jun 26, 2007
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                  Does Medicare pays for J3490 codes by any chance? If
                  they don't pay what is that we have to do inorder to
                  get paid.

                  I would appreciate your thoughts.


                  Contact Details:
                  Joktan R Edison
                  Voice: +9 198490 36217





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                • KIMBERLY SIERRA
                  Medicare does pay for J3490 in some cases. What drugs are you billing for ? May also depend on state your in. I pulled this from Medicare website this applies
                  Message 8 of 15 , Jun 26, 2007
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                    Medicare does pay for J3490 in some cases. What drugs are you billing for ? May also depend on state your in. I pulled this from Medicare website this applies for CA and NE. Hope this helps.
                    Kim
                    Billing for Unlisted Procedures and Unlisted Drugs

                    Recent telephone calls and written inquiries reveal that many billers have questions concerning the reporting of unlisted procedures or unlisted drugs. The following information will guide you in the process.
                    Reference: CPT and HCPCS Coding Books

                    Guidelines for Unlisted Procedure Codes or Not Otherwise Classified Code (NOC):

                    Specific code numbers are designated for reporting NOC procedure codes
                    NOC codes relate to a specific section of the CPT coding book (example: surgery, radiology, pathology, and medicine sections) and are found in the guidelines section of each chapter
                    Enter the NOC code in Item 24D of the CMS-1500 claim form
                    Provide a written description or report of the nature and extent of procedure performed
                    Report should include medical necessity for the procedure
                    Report should include total time, effort, and equipment needed
                    Report should include complexity of symptoms, final diagnosis, physical findings, concurrent problems, and follow-up care
                    NHIC recommends identifying the closest or most similar code to that performed

                    Highlights for Unlisted Drugs or Not Otherwise Classified Code (NOC):

                    Specific code numbers are designated for reporting NOC drugs
                    NOC codes are found in the drug section of the HCPCS coding book
                    Enter either J3490 (unclassified drug), J3590 (unclassified biologic) or J9999 (unclassified antineoplastic) in Item 24D of the CMS-1500 claim form or electronic equivalent
                    Enter name, dosage, and route of administration of drug (only if the drug has more than one route of administration) in Item 19 of the CMS-1500 claim form or electronic equivalent
                    Do not attach invoice. If it is needed, the carrier will request it.

                    6/16/2005


                    Joktan Edison <ejoktan@...> wrote: Does Medicare pays for J3490 codes by any chance? If
                    they don't pay what is that we have to do inorder to
                    get paid.

                    I would appreciate your thoughts.

                    Contact Details:
                    Joktan R Edison
                    Voice: +9 198490 36217


                    __________________________________________________________
                    Finding fabulous fares is fun.
                    Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.
                    http://farechase.yahoo.com/promo-generic-14795097





                    [Non-text portions of this message have been removed]
                  • kishore kumar
                    Nothing..!!!! WE NEED TO DO A HUNGER STRIKE INFRONT OF MEDICARE S OFFICE GATE...!!!! Just kidding Jok.. How are you dude?? Joktan Edison
                    Message 9 of 15 , Jun 29, 2007
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                      Nothing..!!!! WE NEED TO DO A HUNGER STRIKE INFRONT OF MEDICARE'S OFFICE GATE...!!!!

                      Just kidding Jok.. How are you dude??

                      Joktan Edison <ejoktan@...> wrote: Does Medicare pays for J3490 codes by any chance? If
                      they don't pay what is that we have to do inorder to
                      get paid.

                      I would appreciate your thoughts.

                      Contact Details:
                      Joktan R Edison
                      Voice: +9 198490 36217


                      __________________________________________________________
                      Finding fabulous fares is fun.
                      Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.
                      http://farechase.yahoo.com/promo-generic-14795097





                      ---------------------------------
                      Boardwalk for $500? In 2007? Ha!
                      Play Monopoly Here and Now (it's updated for today's economy) at Yahoo! Games.

                      [Non-text portions of this message have been removed]
                    • Joktan Edison
                      We bill for XYLOCAINE and we have this problem in TX. Any updates would really appreciated. ...
                      Message 10 of 15 , Jul 26, 2007
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                        We bill for XYLOCAINE and we have this problem in TX.
                        Any updates would really appreciated.


                        --- KIMBERLY SIERRA <ms2ks@...> wrote:

                        > Medicare does pay for J3490 in some cases. What
                        > drugs are you billing for ? May also depend on state
                        > your in. I pulled this from Medicare website this
                        > applies for CA and NE. Hope this helps.
                        > Kim
                        > Billing for Unlisted Procedures and Unlisted Drugs
                        >
                        > Recent telephone calls and written inquiries
                        > reveal that many billers have questions concerning
                        > the reporting of unlisted procedures or unlisted
                        > drugs. The following information will guide you in
                        > the process.
                        > Reference: CPT and HCPCS Coding Books
                        >
                        > Guidelines for Unlisted Procedure Codes or Not
                        > Otherwise Classified Code (NOC):
                        >
                        > Specific code numbers are designated for
                        > reporting NOC procedure codes
                        > NOC codes relate to a specific section of the CPT
                        > coding book (example: surgery, radiology, pathology,
                        > and medicine sections) and are found in the
                        > guidelines section of each chapter
                        > Enter the NOC code in Item 24D of the CMS-1500
                        > claim form
                        > Provide a written description or report of the
                        > nature and extent of procedure performed
                        > Report should include medical necessity for the
                        > procedure
                        > Report should include total time, effort, and
                        > equipment needed
                        > Report should include complexity of symptoms,
                        > final diagnosis, physical findings, concurrent
                        > problems, and follow-up care
                        > NHIC recommends identifying the closest or most
                        > similar code to that performed
                        >
                        > Highlights for Unlisted Drugs or Not Otherwise
                        > Classified Code (NOC):
                        >
                        > Specific code numbers are designated for
                        > reporting NOC drugs
                        > NOC codes are found in the drug section of the
                        > HCPCS coding book
                        > Enter either J3490 (unclassified drug), J3590
                        > (unclassified biologic) or J9999 (unclassified
                        > antineoplastic) in Item 24D of the CMS-1500 claim
                        > form or electronic equivalent
                        > Enter name, dosage, and route of administration
                        > of drug (only if the drug has more than one route of
                        > administration) in Item 19 of the CMS-1500 claim
                        > form or electronic equivalent
                        > Do not attach invoice. If it is needed, the
                        > carrier will request it.
                        >
                        > 6/16/2005
                        >
                        >
                        > Joktan Edison <ejoktan@...> wrote:
                        > Does Medicare pays for J3490 codes by any chance? If
                        > they don't pay what is that we have to do inorder to
                        > get paid.
                        >
                        > I would appreciate your thoughts.
                        >
                        > Contact Details:
                        > Joktan R Edison
                        > Voice: +9 198490 36217
                        >
                        >
                        >
                        __________________________________________________________
                        > Finding fabulous fares is fun.
                        > Let Yahoo! FareChase search your favorite travel
                        > sites to find flight and hotel bargains.
                        > http://farechase.yahoo.com/promo-generic-14795097
                        >
                        >
                        >
                        >
                        >
                        > [Non-text portions of this message have been
                        > removed]
                        >
                        >







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                      • B Burgess
                        Medicare will only pay for Xylocaine (Lidocaine) which is given IV. Joktan Edison wrote: We bill for XYLOCAINE and we have this problem in
                        Message 11 of 15 , Jul 26, 2007
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                          Medicare will only pay for Xylocaine (Lidocaine) which is given IV.



                          Joktan Edison <ejoktan@...> wrote:
                          We bill for XYLOCAINE and we have this problem in TX.
                          Any updates would really appreciated.

                          --- KIMBERLY SIERRA <ms2ks@...> wrote:

                          > Medicare does pay for J3490 in some cases. What
                          > drugs are you billing for ? May also depend on state
                          > your in. I pulled this from Medicare website this
                          > applies for CA and NE. Hope this helps.
                          > Kim
                          > Billing for Unlisted Procedures and Unlisted Drugs
                          >
                          > Recent telephone calls and written inquiries
                          > reveal that many billers have questions concerning
                          > the reporting of unlisted procedures or unlisted
                          > drugs. The following information will guide you in
                          > the process.
                          > Reference: CPT and HCPCS Coding Books
                          >
                          > Guidelines for Unlisted Procedure Codes or Not
                          > Otherwise Classified Code (NOC):
                          >
                          > Specific code numbers are designated for
                          > reporting NOC procedure codes
                          > NOC codes relate to a specific section of the CPT
                          > coding book (example: surgery, radiology, pathology,
                          > and medicine sections) and are found in the
                          > guidelines section of each chapter
                          > Enter the NOC code in Item 24D of the CMS-1500
                          > claim form
                          > Provide a written description or report of the
                          > nature and extent of procedure performed
                          > Report should include medical necessity for the
                          > procedure
                          > Report should include total time, effort, and
                          > equipment needed
                          > Report should include complexity of symptoms,
                          > final diagnosis, physical findings, concurrent
                          > problems, and follow-up care
                          > NHIC recommends identifying the closest or most
                          > similar code to that performed
                          >
                          > Highlights for Unlisted Drugs or Not Otherwise
                          > Classified Code (NOC):
                          >
                          > Specific code numbers are designated for
                          > reporting NOC drugs
                          > NOC codes are found in the drug section of the
                          > HCPCS coding book
                          > Enter either J3490 (unclassified drug), J3590
                          > (unclassified biologic) or J9999 (unclassified
                          > antineoplastic) in Item 24D of the CMS-1500 claim
                          > form or electronic equivalent
                          > Enter name, dosage, and route of administration
                          > of drug (only if the drug has more than one route of
                          > administration) in Item 19 of the CMS-1500 claim
                          > form or electronic equivalent
                          > Do not attach invoice. If it is needed, the
                          > carrier will request it.
                          >
                          > 6/16/2005
                          >
                          >
                          > Joktan Edison <ejoktan@...> wrote:
                          > Does Medicare pays for J3490 codes by any chance? If
                          > they don't pay what is that we have to do inorder to
                          > get paid.
                          >
                          > I would appreciate your thoughts.
                          >
                          > Contact Details:
                          > Joktan R Edison
                          > Voice: +9 198490 36217
                          >
                          >
                          >
                          __________________________________________________________
                          > Finding fabulous fares is fun.
                          > Let Yahoo! FareChase search your favorite travel
                          > sites to find flight and hotel bargains.
                          > http://farechase.yahoo.com/promo-generic-14795097
                          >
                          >
                          >
                          >
                          >
                          > [Non-text portions of this message have been
                          > removed]
                          >
                          >

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                          ---------------------------------
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                          [Non-text portions of this message have been removed]
                        • Joktan Edison
                          Can you please be more specific Barbara. I would appreciate your feedback ... http://new.toolbar.yahoo.com/toolbar/features/mail/index.php ...
                          Message 12 of 15 , Jul 26, 2007
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                            Can you please be more specific Barbara. I would
                            appreciate your feedback

                            --- B Burgess <granbfly@...> wrote:

                            > Medicare will only pay for Xylocaine (Lidocaine)
                            > which is given IV.
                            >
                            >
                            >
                            > Joktan Edison <ejoktan@...> wrote:
                            > We bill for XYLOCAINE and we have this
                            > problem in TX.
                            > Any updates would really appreciated.
                            >
                            > --- KIMBERLY SIERRA <ms2ks@...> wrote:
                            >
                            > > Medicare does pay for J3490 in some cases. What
                            > > drugs are you billing for ? May also depend on
                            > state
                            > > your in. I pulled this from Medicare website this
                            > > applies for CA and NE. Hope this helps.
                            > > Kim
                            > > Billing for Unlisted Procedures and Unlisted Drugs
                            > >
                            > > Recent telephone calls and written inquiries
                            > > reveal that many billers have questions concerning
                            > > the reporting of unlisted procedures or unlisted
                            > > drugs. The following information will guide you in
                            > > the process.
                            > > Reference: CPT and HCPCS Coding Books
                            > >
                            > > Guidelines for Unlisted Procedure Codes or Not
                            > > Otherwise Classified Code (NOC):
                            > >
                            > > Specific code numbers are designated for
                            > > reporting NOC procedure codes
                            > > NOC codes relate to a specific section of the CPT
                            > > coding book (example: surgery, radiology,
                            > pathology,
                            > > and medicine sections) and are found in the
                            > > guidelines section of each chapter
                            > > Enter the NOC code in Item 24D of the CMS-1500
                            > > claim form
                            > > Provide a written description or report of the
                            > > nature and extent of procedure performed
                            > > Report should include medical necessity for the
                            > > procedure
                            > > Report should include total time, effort, and
                            > > equipment needed
                            > > Report should include complexity of symptoms,
                            > > final diagnosis, physical findings, concurrent
                            > > problems, and follow-up care
                            > > NHIC recommends identifying the closest or most
                            > > similar code to that performed
                            > >
                            > > Highlights for Unlisted Drugs or Not Otherwise
                            > > Classified Code (NOC):
                            > >
                            > > Specific code numbers are designated for
                            > > reporting NOC drugs
                            > > NOC codes are found in the drug section of the
                            > > HCPCS coding book
                            > > Enter either J3490 (unclassified drug), J3590
                            > > (unclassified biologic) or J9999 (unclassified
                            > > antineoplastic) in Item 24D of the CMS-1500 claim
                            > > form or electronic equivalent
                            > > Enter name, dosage, and route of administration
                            > > of drug (only if the drug has more than one route
                            > of
                            > > administration) in Item 19 of the CMS-1500 claim
                            > > form or electronic equivalent
                            > > Do not attach invoice. If it is needed, the
                            > > carrier will request it.
                            > >
                            > > 6/16/2005
                            > >
                            > >
                            > > Joktan Edison <ejoktan@...> wrote:
                            > > Does Medicare pays for J3490 codes by any chance?
                            > If
                            > > they don't pay what is that we have to do inorder
                            > to
                            > > get paid.
                            > >
                            > > I would appreciate your thoughts.
                            > >
                            > > Contact Details:
                            > > Joktan R Edison
                            > > Voice: +9 198490 36217
                            > >
                            > >
                            > >
                            >
                            __________________________________________________________
                            > > Finding fabulous fares is fun.
                            > > Let Yahoo! FareChase search your favorite travel
                            > > sites to find flight and hotel bargains.
                            > > http://farechase.yahoo.com/promo-generic-14795097
                            > >
                            > >
                            > >
                            > >
                            > >
                            > > [Non-text portions of this message have been
                            > > removed]
                            > >
                            > >
                            >
                            >
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                            > wherever you're surfing.
                            >
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                            >
                            >
                            >
                            >
                            > ---------------------------------
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                            > Play Monopoly Here and Now (it's updated for today's
                            > economy) at Yahoo! Games.
                            >
                            > [Non-text portions of this message have been
                            > removed]
                            >
                            >







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                          • B Burgess
                            who is your local m care carrier ? Barb Joktan Edison wrote: Can you please be more specific Barbara. I would appreciate your feedback ...
                            Message 13 of 15 , Jul 26, 2007
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                              who is your local m'care carrier ?

                              Barb

                              Joktan Edison <ejoktan@...> wrote:
                              Can you please be more specific Barbara. I would
                              appreciate your feedback

                              --- B Burgess <granbfly@...> wrote:

                              > Medicare will only pay for Xylocaine (Lidocaine)
                              > which is given IV.
                              >
                              >
                              >
                              > Joktan Edison <ejoktan@...> wrote:
                              > We bill for XYLOCAINE and we have this
                              > problem in TX.
                              > Any updates would really appreciated.
                              >
                              > --- KIMBERLY SIERRA <ms2ks@...> wrote:
                              >
                              > > Medicare does pay for J3490 in some cases. What
                              > > drugs are you billing for ? May also depend on
                              > state
                              > > your in. I pulled this from Medicare website this
                              > > applies for CA and NE. Hope this helps.
                              > > Kim
                              > > Billing for Unlisted Procedures and Unlisted Drugs
                              > >
                              > > Recent telephone calls and written inquiries
                              > > reveal that many billers have questions concerning
                              > > the reporting of unlisted procedures or unlisted
                              > > drugs. The following information will guide you in
                              > > the process.
                              > > Reference: CPT and HCPCS Coding Books
                              > >
                              > > Guidelines for Unlisted Procedure Codes or Not
                              > > Otherwise Classified Code (NOC):
                              > >
                              > > Specific code numbers are designated for
                              > > reporting NOC procedure codes
                              > > NOC codes relate to a specific section of the CPT
                              > > coding book (example: surgery, radiology,
                              > pathology,
                              > > and medicine sections) and are found in the
                              > > guidelines section of each chapter
                              > > Enter the NOC code in Item 24D of the CMS-1500
                              > > claim form
                              > > Provide a written description or report of the
                              > > nature and extent of procedure performed
                              > > Report should include medical necessity for the
                              > > procedure
                              > > Report should include total time, effort, and
                              > > equipment needed
                              > > Report should include complexity of symptoms,
                              > > final diagnosis, physical findings, concurrent
                              > > problems, and follow-up care
                              > > NHIC recommends identifying the closest or most
                              > > similar code to that performed
                              > >
                              > > Highlights for Unlisted Drugs or Not Otherwise
                              > > Classified Code (NOC):
                              > >
                              > > Specific code numbers are designated for
                              > > reporting NOC drugs
                              > > NOC codes are found in the drug section of the
                              > > HCPCS coding book
                              > > Enter either J3490 (unclassified drug), J3590
                              > > (unclassified biologic) or J9999 (unclassified
                              > > antineoplastic) in Item 24D of the CMS-1500 claim
                              > > form or electronic equivalent
                              > > Enter name, dosage, and route of administration
                              > > of drug (only if the drug has more than one route
                              > of
                              > > administration) in Item 19 of the CMS-1500 claim
                              > > form or electronic equivalent
                              > > Do not attach invoice. If it is needed, the
                              > > carrier will request it.
                              > >
                              > > 6/16/2005
                              > >
                              > >
                              > > Joktan Edison <ejoktan@...> wrote:
                              > > Does Medicare pays for J3490 codes by any chance?
                              > If
                              > > they don't pay what is that we have to do inorder
                              > to
                              > > get paid.
                              > >
                              > > I would appreciate your thoughts.
                              > >
                              > > Contact Details:
                              > > Joktan R Edison
                              > > Voice: +9 198490 36217
                              > >
                              > >
                              > >
                              >
                              __________________________________________________________
                              > > Finding fabulous fares is fun.
                              > > Let Yahoo! FareChase search your favorite travel
                              > > sites to find flight and hotel bargains.
                              > > http://farechase.yahoo.com/promo-generic-14795097
                              > >
                              > >
                              > >
                              > >
                              > >
                              > > [Non-text portions of this message have been
                              > > removed]
                              > >
                              > >
                              >
                              >
                              __________________________________________________________
                              > Get the Yahoo! toolbar and be alerted to new email
                              > wherever you're surfing.
                              >
                              http://new.toolbar.yahoo.com/toolbar/features/mail/index.php
                              >
                              >
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                              >
                              >
                              > ---------------------------------
                              > Boardwalk for $500? In 2007? Ha!
                              > Play Monopoly Here and Now (it's updated for today's
                              > economy) at Yahoo! Games.
                              >
                              > [Non-text portions of this message have been
                              > removed]
                              >
                              >

                              __________________________________________________________
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                              ---------------------------------
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                              [Non-text portions of this message have been removed]
                            • Joktan Edison
                              We are in Texas Barbara. I would appreciate your help ... http://new.toolbar.yahoo.com/toolbar/features/mail/index.php ...
                              Message 14 of 15 , Jul 26, 2007
                              • 0 Attachment
                                We are in Texas Barbara. I would appreciate your help


                                --- B Burgess <granbfly@...> wrote:

                                > who is your local m'care carrier ?
                                >
                                > Barb
                                >
                                > Joktan Edison <ejoktan@...> wrote:
                                > Can you please be more specific Barbara. I
                                > would
                                > appreciate your feedback
                                >
                                > --- B Burgess <granbfly@...> wrote:
                                >
                                > > Medicare will only pay for Xylocaine (Lidocaine)
                                > > which is given IV.
                                > >
                                > >
                                > >
                                > > Joktan Edison <ejoktan@...> wrote:
                                > > We bill for XYLOCAINE and we have this
                                > > problem in TX.
                                > > Any updates would really appreciated.
                                > >
                                > > --- KIMBERLY SIERRA <ms2ks@...> wrote:
                                > >
                                > > > Medicare does pay for J3490 in some cases. What
                                > > > drugs are you billing for ? May also depend on
                                > > state
                                > > > your in. I pulled this from Medicare website
                                > this
                                > > > applies for CA and NE. Hope this helps.
                                > > > Kim
                                > > > Billing for Unlisted Procedures and Unlisted
                                > Drugs
                                > > >
                                > > > Recent telephone calls and written inquiries
                                > > > reveal that many billers have questions
                                > concerning
                                > > > the reporting of unlisted procedures or unlisted
                                > > > drugs. The following information will guide you
                                > in
                                > > > the process.
                                > > > Reference: CPT and HCPCS Coding Books
                                > > >
                                > > > Guidelines for Unlisted Procedure Codes or Not
                                > > > Otherwise Classified Code (NOC):
                                > > >
                                > > > Specific code numbers are designated for
                                > > > reporting NOC procedure codes
                                > > > NOC codes relate to a specific section of the
                                > CPT
                                > > > coding book (example: surgery, radiology,
                                > > pathology,
                                > > > and medicine sections) and are found in the
                                > > > guidelines section of each chapter
                                > > > Enter the NOC code in Item 24D of the CMS-1500
                                > > > claim form
                                > > > Provide a written description or report of the
                                > > > nature and extent of procedure performed
                                > > > Report should include medical necessity for the
                                > > > procedure
                                > > > Report should include total time, effort, and
                                > > > equipment needed
                                > > > Report should include complexity of symptoms,
                                > > > final diagnosis, physical findings, concurrent
                                > > > problems, and follow-up care
                                > > > NHIC recommends identifying the closest or most
                                > > > similar code to that performed
                                > > >
                                > > > Highlights for Unlisted Drugs or Not Otherwise
                                > > > Classified Code (NOC):
                                > > >
                                > > > Specific code numbers are designated for
                                > > > reporting NOC drugs
                                > > > NOC codes are found in the drug section of the
                                > > > HCPCS coding book
                                > > > Enter either J3490 (unclassified drug), J3590
                                > > > (unclassified biologic) or J9999 (unclassified
                                > > > antineoplastic) in Item 24D of the CMS-1500
                                > claim
                                > > > form or electronic equivalent
                                > > > Enter name, dosage, and route of administration
                                > > > of drug (only if the drug has more than one
                                > route
                                > > of
                                > > > administration) in Item 19 of the CMS-1500 claim
                                > > > form or electronic equivalent
                                > > > Do not attach invoice. If it is needed, the
                                > > > carrier will request it.
                                > > >
                                > > > 6/16/2005
                                > > >
                                > > >
                                > > > Joktan Edison <ejoktan@...> wrote:
                                > > > Does Medicare pays for J3490 codes by any
                                > chance?
                                > > If
                                > > > they don't pay what is that we have to do
                                > inorder
                                > > to
                                > > > get paid.
                                > > >
                                > > > I would appreciate your thoughts.
                                > > >
                                > > > Contact Details:
                                > > > Joktan R Edison
                                > > > Voice: +9 198490 36217
                                > > >
                                > > >
                                > > >
                                > >
                                >
                                __________________________________________________________
                                > > > Finding fabulous fares is fun.
                                > > > Let Yahoo! FareChase search your favorite travel
                                > > > sites to find flight and hotel bargains.
                                > > >
                                > http://farechase.yahoo.com/promo-generic-14795097
                                > > >
                                > > >
                                > > >
                                > > >
                                > > >
                                > > > [Non-text portions of this message have been
                                > > > removed]
                                > > >
                                > > >
                                > >
                                > >
                                >
                                __________________________________________________________
                                > > Get the Yahoo! toolbar and be alerted to new email
                                > > wherever you're surfing.
                                > >
                                >
                                http://new.toolbar.yahoo.com/toolbar/features/mail/index.php
                                > >
                                > >
                                > >
                                > >
                                > >
                                > > ---------------------------------
                                > > Boardwalk for $500? In 2007? Ha!
                                > > Play Monopoly Here and Now (it's updated for
                                > today's
                                > > economy) at Yahoo! Games.
                                > >
                                > > [Non-text portions of this message have been
                                > > removed]
                                > >
                                > >
                                >
                                >
                                __________________________________________________________
                                > Be a better Heartthrob. Get better relationship
                                > answers from someone who knows. Yahoo! Answers -
                                > Check it out.
                                >
                                http://answers.yahoo.com/dir/?link=list&sid=396545433
                                >
                                >
                                >
                                >
                                >
                                > ---------------------------------
                                > Moody friends. Drama queens. Your life? Nope! -
                                > their life, your story.
                                > Play Sims Stories at Yahoo! Games.
                                >
                                > [Non-text portions of this message have been
                                > removed]
                                >
                                >







                                ____________________________________________________________________________________
                                Choose the right car based on your needs. Check out Yahoo! Autos new Car Finder tool.
                                http://autos.yahoo.com/carfinder/
                              • B Burgess
                                yes, but who is your m care carrier ? I m in alabama and ours is cahaba. You may want to check your m care website for guidance. Actually, I just checked ours
                                Message 15 of 15 , Jul 26, 2007
                                • 0 Attachment
                                  yes, but who is your m'care carrier ? I'm in alabama and ours is cahaba. You may want to check your m'care website for guidance. Actually, I just checked ours and see that lidocaine actually is under the list now for J3490 (see https://www.cahabagba.com/part_b/claims/noc_apr_jun2007.htm and it is a whole 7 cents reimbursement. Our practice does not bill for it when given for something like a joint or trigger point injection. Xylo is cheap and it would cost more to file the cliam than to worry about the 7 cents. If you're giving it IV for a cardiac issue, that's a different story. Then you would use the J2001 code.

                                  Barb

                                  Joktan Edison <ejoktan@...> wrote:
                                  We are in Texas Barbara. I would appreciate your help

                                  --- B Burgess <granbfly@...> wrote:

                                  > who is your local m'care carrier ?
                                  >
                                  > Barb
                                  >
                                  > Joktan Edison <ejoktan@...> wrote:
                                  > Can you please be more specific Barbara. I
                                  > would
                                  > appreciate your feedback
                                  >
                                  > --- B Burgess <granbfly@...> wrote:
                                  >
                                  > > Medicare will only pay for Xylocaine (Lidocaine)
                                  > > which is given IV.
                                  > >
                                  > >
                                  > >
                                  > > Joktan Edison <ejoktan@...> wrote:
                                  > > We bill for XYLOCAINE and we have this
                                  > > problem in TX.
                                  > > Any updates would really appreciated.
                                  > >
                                  > > --- KIMBERLY SIERRA <ms2ks@...> wrote:
                                  > >
                                  > > > Medicare does pay for J3490 in some cases. What
                                  > > > drugs are you billing for ? May also depend on
                                  > > state
                                  > > > your in. I pulled this from Medicare website
                                  > this
                                  > > > applies for CA and NE. Hope this helps.
                                  > > > Kim
                                  > > > Billing for Unlisted Procedures and Unlisted
                                  > Drugs
                                  > > >
                                  > > > Recent telephone calls and written inquiries
                                  > > > reveal that many billers have questions
                                  > concerning
                                  > > > the reporting of unlisted procedures or unlisted
                                  > > > drugs. The following information will guide you
                                  > in
                                  > > > the process.
                                  > > > Reference: CPT and HCPCS Coding Books
                                  > > >
                                  > > > Guidelines for Unlisted Procedure Codes or Not
                                  > > > Otherwise Classified Code (NOC):
                                  > > >
                                  > > > Specific code numbers are designated for
                                  > > > reporting NOC procedure codes
                                  > > > NOC codes relate to a specific section of the
                                  > CPT
                                  > > > coding book (example: surgery, radiology,
                                  > > pathology,
                                  > > > and medicine sections) and are found in the
                                  > > > guidelines section of each chapter
                                  > > > Enter the NOC code in Item 24D of the CMS-1500
                                  > > > claim form
                                  > > > Provide a written description or report of the
                                  > > > nature and extent of procedure performed
                                  > > > Report should include medical necessity for the
                                  > > > procedure
                                  > > > Report should include total time, effort, and
                                  > > > equipment needed
                                  > > > Report should include complexity of symptoms,
                                  > > > final diagnosis, physical findings, concurrent
                                  > > > problems, and follow-up care
                                  > > > NHIC recommends identifying the closest or most
                                  > > > similar code to that performed
                                  > > >
                                  > > > Highlights for Unlisted Drugs or Not Otherwise
                                  > > > Classified Code (NOC):
                                  > > >
                                  > > > Specific code numbers are designated for
                                  > > > reporting NOC drugs
                                  > > > NOC codes are found in the drug section of the
                                  > > > HCPCS coding book
                                  > > > Enter either J3490 (unclassified drug), J3590
                                  > > > (unclassified biologic) or J9999 (unclassified
                                  > > > antineoplastic) in Item 24D of the CMS-1500
                                  > claim
                                  > > > form or electronic equivalent
                                  > > > Enter name, dosage, and route of administration
                                  > > > of drug (only if the drug has more than one
                                  > route
                                  > > of
                                  > > > administration) in Item 19 of the CMS-1500 claim
                                  > > > form or electronic equivalent
                                  > > > Do not attach invoice. If it is needed, the
                                  > > > carrier will request it.
                                  > > >
                                  > > > 6/16/2005
                                  > > >
                                  > > >
                                  > > > Joktan Edison <ejoktan@...> wrote:
                                  > > > Does Medicare pays for J3490 codes by any
                                  > chance?
                                  > > If
                                  > > > they don't pay what is that we have to do
                                  > inorder
                                  > > to
                                  > > > get paid.
                                  > > >
                                  > > > I would appreciate your thoughts.
                                  > > >
                                  > > > Contact Details:
                                  > > > Joktan R Edison
                                  > > > Voice: +9 198490 36217
                                  > > >
                                  > > >
                                  > > >
                                  > >
                                  >
                                  __________________________________________________________
                                  > > > Finding fabulous fares is fun.
                                  > > > Let Yahoo! FareChase search your favorite travel
                                  > > > sites to find flight and hotel bargains.
                                  > > >
                                  > http://farechase.yahoo.com/promo-generic-14795097
                                  > > >
                                  > > >
                                  > > >
                                  > > >
                                  > > >
                                  > > > [Non-text portions of this message have been
                                  > > > removed]
                                  > > >
                                  > > >
                                  > >
                                  > >
                                  >
                                  __________________________________________________________
                                  > > Get the Yahoo! toolbar and be alerted to new email
                                  > > wherever you're surfing.
                                  > >
                                  >
                                  http://new.toolbar.yahoo.com/toolbar/features/mail/index.php
                                  > >
                                  > >
                                  > >
                                  > >
                                  > >
                                  > > ---------------------------------
                                  > > Boardwalk for $500? In 2007? Ha!
                                  > > Play Monopoly Here and Now (it's updated for
                                  > today's
                                  > > economy) at Yahoo! Games.
                                  > >
                                  > > [Non-text portions of this message have been
                                  > > removed]
                                  > >
                                  > >
                                  >
                                  >
                                  __________________________________________________________
                                  > Be a better Heartthrob. Get better relationship
                                  > answers from someone who knows. Yahoo! Answers -
                                  > Check it out.
                                  >
                                  http://answers.yahoo.com/dir/?link=list&sid=396545433
                                  >
                                  >
                                  >
                                  >
                                  >
                                  > ---------------------------------
                                  > Moody friends. Drama queens. Your life? Nope! -
                                  > their life, your story.
                                  > Play Sims Stories at Yahoo! Games.
                                  >
                                  > [Non-text portions of this message have been
                                  > removed]
                                  >
                                  >

                                  __________________________________________________________
                                  Choose the right car based on your needs. Check out Yahoo! Autos new Car Finder tool.
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                                  ---------------------------------
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