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22 kwi 2024 · Also, the National Drug Code (NDC) number will need to be reported on the claim to alert the insurance carrier as to which strength/concentration was used (J1020, J1030, J1040). Methotrexate HCPCS code J9250 (Methotrexate sodium, 5 mg) has been deleted.
1 kwi 2024 · You will bill the J1010 for all Depo-Medrol injections, it is replacing the J1020, J1030, & J1040. The NDC# on the claim will alert the insurance carrier as to which strength/concentration was used (J1020, J1030, J1040).
9 kwi 2024 · We have NDC numbers for the 40mg vials and 80mg vials, but nothing for 1mg. Do we just use the NDC for one of the others? I haven't found anything in my search yet. Our Medicare Palmetto GBA has excluded J1010 for reimbursement (J1010 Procedure Status = E; there are no RVUs, payment policy indicators do not apply).
15 lis 2024 · List of NDC codes used with HCPCS code J1030. Special coverage instructions apply. NDC HCPCS Crosswalk for easy coding.
Do I have to bill with NCS information in addition to HCPCS/CPT codes? Yes. You must submit the NDC, NDC units of measure and NDC quantity in addition to the applicable HCPCS or CPT code(s) and the number of HCPCS/CPT units. You must continue to enter a valid HCPCS or CPT code with units of service on the claim form on the basis for reimbursement.
The HCPCS code for 40mg would be J1030, but my understanding is that because the NDC number we'll report is linked to the 80 mg dose, and the NDC and HCPCS have to match, we're required to report J1040, the 80mg code. This makes me uncomfortable.
There are several methods by which users may enter NDC codes, and these are outlined below. NDC (National Drug Codes) are required by payers when billing for drugs. The FDA publishes the listed NDC numbers in the NDC Directory, which is updated daily.
