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Re: Worker's Comp Billing

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  • 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 1 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 2 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





        ____________________________________________________________________________________
        Finding fabulous fares is fun.
        Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains.
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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 3 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 4 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 5 of 15 , Jul 26, 2007
            • 0 Attachment
              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 6 of 15 , Jul 26, 2007
              • 0 Attachment
                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]
              • 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 7 of 15 , Jul 26, 2007
                • 0 Attachment
                  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
                • 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 8 of 15 , Jul 26, 2007
                  • 0 Attachment
                    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]
                  • Joktan Edison
                    We are in Texas Barbara. I would appreciate your help ... http://new.toolbar.yahoo.com/toolbar/features/mail/index.php ...
                    Message 9 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.
                      > > >
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                    • 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 10 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
                        > > >
                        > > >
                        > > >
                        > >
                        >
                        __________________________________________________________
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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]
                        > >
                        > >
                        >
                        >
                        __________________________________________________________
                        > 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
                        >
                        >
                        >
                        >
                        >
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                        > their life, your story.
                        > Play Sims Stories at Yahoo! Games.
                        >
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                        >
                        >

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