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CODING & BILLING
with the targeted training necessary to accurately generate revenue.
3. Choose an outside agent for external coding review. Ask several outside agents for quotes on providing coding review services. Make sure
they know it's not your intention to outsource your coding. Tell them
you want results reported in a way that identifies significant errors, or
those that would affect revenue positively or negatively. Request a
OPHTHALMIC MITOMYCIN
Mitosol Gets New HCPCS Code
C
MS has created a new HCPCS code for ophthalmic mitomycin,
which is sometimes used in trabeculectomy surgery to inhibit
scar formation. As of Jan. 1, you can use HCPCS code J7315
(Mitomycin, ophthalmic, 0.2mg) to report Mitosol.
Per CMS, code J7315 has an N1 payment indicator, which means its
payment is packaged into the fee for the main procedure; so for
Medicare there is no separate payment for J7315. Private payors may or
may not reimburse this separately.
In February 2012, the FDA approved Mitosol, produced by Mobius
Therapeutics, as an adjunct to trabeculectomy for the treatment of
refractory glaucoma. It has other FDA-pending ophthalmic uses, such as
in pterygium excision to prevent recurrence.
— Denis Rodriguez, CPC
Mr. Rodriguez (denis.rodriguez@asc-coders.com) is a senior ambulatory surgery center coder and compliance auditor for The Coding
Network.
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