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  1. sarah8873

    Wiki Denials of high dollar drugs with JW for wastage

    Updated regulations for JW modifier in addition to now having to apply JZ mod to single use drug charges without wastage. We now have to contend with wastage putting the charges over MUE edits and denials of all the drug charges. This is happening with straight Medicare and at least one of our...
  2. sarah8873

    Wiki Qutenza J7336 application CPT/HCPCS

    I am a facility coder for a hospital system that is primarily Medicare and Medicaid patients. I also work denials, NCCI edits, payer specific edits etc for OPPS billing. Our pain management and wound care clinics want to start using and charging for Qutenza capsaicin patches and application...
  3. sarah8873

    Wiki Modifier PO versus PN

    PO vs PN It has to do with the date in which these clinics were given the off campus status. PO is for the clinics off site that were assigned this classification prior to 1/1/2017 ( I believe this is the correct date ). After that, the clinics that hadn't yet been assigned this off site/campus...
  4. sarah8873

    Wiki documentation requiremements for flu vaccines

    Documentation Simple questionnaire.. allergie to eggs? Current ill ? Ever had reaction before ? Then pt signs for consent and usually nurse as witness. Z23 has to be in dx or it will not pay. And admin code G0008 has to be used. There is a new flu code coming out, but won't start paying til Jan...
  5. sarah8873

    Wiki Medicare and CPT code 90714

    Medicare will not pay for this I work on the facility side for hospital outpt. Medicare will rarely pay for this, but it would have to be in an ED setting with an open wound/laceration from something such as a metal object, cut from a metal fence, or rusty nail etc. They would pay for a rabies...
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