tci Outpatient Facility Coding Alert - 2013 Issue 12

You Be the Coder: Extra Payment for J0171

Question: Medicare has been denying our claims billing epinephrine code J0171 when the drug was administered during surgery. Is there an MUE edits we don’t know about? If not, how should we be filing the claim? Wyoming Subscriber Answer: When you look up code J0171 (Injection, adrenalin, epinephrine, 0.1 mg) in your HCPCS book, you’ll find that the code has an ASC Status Indicator of N1. This means the code is considered to be a “packaged service/item” with no separate payment allowed. Continue reporting J0171 for data collection or documentation purposes if you like, but...

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