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Ask a Rev Cycle Expert: Are PLA codes mostly for physician billing?

Are PLA codes considered to be mostly for physician billing? For 0241U, the manufacture stated the PLA code was to be used to report for their test. Is it appropriate for hospital billing to report 0241U, or should we use 87637?

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Ask a Rev Cycle Expert: Is there a new HCPCS code for Hemospray®?

Is there a new HCPCS code for Hemospray®?

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Ask a Rev Cycle Expert: Do We Use JG Modifier with M1145?

Based on the Most Favored Nation (MFN) Model Interim Final Rule (IFC), it appears we would still add the JG modifier for 340b purchased drugs, but we would not use the JG modifier on the add-on code M1145. Please see the included excerpt and confirm the JG modifier is not needed with M1145.

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Ask a Rev Cycle Expert: Token or No Charge for COVID-19 Drug Codes?

For the new COVID-19 "drug" codes provided below, should we bill a "token" charge on the claim? Drugs are provided free (at this point), and guidance is "No" charge if provided for free, but would like to confirm proper coding and claim submission as I have seen it referenced both ways, to add a token charge, and to not bill at all!

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Ask a Rev Cycle Expert: Is CPT® 71271 replacing HCPCS G0297?

CPT® 71271 is a new code for 2021: CT, thorax, low dose for lung cancer screening without contrast material. HCPCS code G0297 is the current code: Low dose CT scan for lung cancer screening. Is 71271 replacing G0297 for 2021?

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Ask a Rev Cycle Expert: Appropriate Billing for Bamlanivimab?

Can you clarify appropriate billing for the use of bamlanivimab? Is there a 'minimal' charge that is required when the drug is provided to the facility at no cost?

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