How to make Effective Use of 'J-codes' in Pharmacy Billing


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J codes or HCPCS Level-II codes represent medical procedure codes, these codes are represented in alphanumeric format. Primarily used for non-physician purposes such as ambulance services and prosthetic devices. For billing purpose, this makes use of J codes critical for the pharmacist to understand and interpret.

Keeping in mind the time constraints for the pharmacist and the level of knowledge for beginner or expert level pharmacist, we have created an E-Book covering all the necessary topics to understand the J codes significance in pharmacy billing.

Brief Introduction of the E-book

What are J-codes?

J codes represent non-physician supplies not covered in CPT-4 codes (Level I). Level II or J codes are maintained by US center of Medicare and Medicaid Services (CMS). The E-Book explains the brief background of J codes.

Types of Level II codes

Level II codes are composed of a single alphabet in the range of A to V followed by numeric four digits. The chapter explains the significance of the alphabet.

Converting HCPCS/CPT units to NDC units

This chapter explains you the step by step process to be followed for filling a claim to bill a drug. The process is explained with an example.

Information required for billing unlisted J code

If a claim is to be submitted with an unlisted J code & there are no CPT/HCPCS code for the drug being administered. The provider needs to provide certain information related to the drug. The E-book also lists the Code Glossary for the pharmacy & also miscellaneous codes with all unlisted drugs categories which are not coded.

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