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Epinephrine

Marlene Posted Mon 25th of November, 2013 17:50:01 PM

We have been receiving denials from Medicare for billing the Epinephrine J0171. Can anyone tell me if this is a MUE edit? Are others having this issue and how do you get around it to get the claim billed? We are a facility Hospital and it was given during surgery. Thanks in Advance....
Karin Paasch

SuperCoder Answered Mon 25th of November, 2013 18:26:53 PM

You'll notice in your HCPCs book, code J0171 has an ASC Status Indicator of N1. This means "packaged service/item; no separate payment made."

Marlene Posted Thu 09th of January, 2014 16:03:23 PM

We are not a APC facility. We are a hospital CAH. Do you feel that would matter as far as not allowing payment?

SuperCoder Answered Thu 09th of January, 2014 17:35:55 PM

If you code for a hospital-owned clinic or practice, let the facility handle the supply coding. Because the practice has a contract with the hospital, the hospital bills for all drugs and supplies used there. The practice reports only the physician’s services.

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