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Oasis billing

Susan Posted Tue 11th of December, 2012 18:59:16 PM

How do we get reimbursed for Q4124

SuperCoder Answered Wed 12th of December, 2012 18:39:29 PM

Effective January 1, 2012, the Centers for Medicare & Medicaid Services (CMS) assigned a new brand-specific Level II HCPCS code, Q4124, to OASIS® Ultra Tri-Layer Matrix. The HCPCS code for OASIS® Wound Matrix (Q4102) remains the same for 2012. CMS has indicated that these brand-specific HCPCS codes are applicable for all sites of service that use the OASIS® Matrix products.

When required and/or appropriate, report the name of the product, its size, its product number, and the invoice price per piece in the appropriate field of a paper claim or in the narrative field of an electronic claim
The descriptions for HCPCS codes Q4102 and Q4124 refer to "per square centimeter"
Examples:
3 cm x 3.5 cm = 10.5 sq cm
3 cm x 7 cm = 21 sq cm
5 cm x 7 cm = 35 sq cm
7 cm x 10 cm = 70 sq cm
7 cm x 20 cm = 140 sq cm
Physicians should document and report the number of square centimeters used and discarded for each application. The Medicare program provides payment for the amount of the drug or biological discarded as well as the dose administered, up to the amount of the drug or biological as indicated on the vial or package label.

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