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Elizabeth M. Whitehorn, Director

Provider Notice Issued 07/19/2018

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Date:   July 19, 2018

 

To:       Participating Physicians; Advanced Practice Nurses (APNs); and Podiatrists

 

Re:      Discontinue Use of CPT Code 99070 for Items and Supplies Dispensed in the Office Setting

 

 

 

 

This notice directs providers to begin using actual item and supply HCPCS codes instead of the unlisted code 99070 for items and supplies dispensed in the office setting beginning October 1, 2018.

 

Physicians and APNs

 

Effective for dates of service on and after October 1, 2018, practitioners may no longer use unlisted procedure code 99070 for items and supplies dispensed in the office setting. A list of HCPCS codes of common items dispensed in the office that will be reimbursable by HFS is included with this notice. These HCPCS codes will be added to the Practitioner Fee Schedule effective October 1, 2018.

 

Podiatrists

 

Effective for dates of service on and after October 1, 2018, podiatrists may no longer use unlisted procedure code 99070 for items and supplies dispensed in the office setting. Procedure code A9999 – Miscellaneous DME Supply or Accessory, Not Otherwise Specified will be added to the Podiatric Fee Schedule effective October 1, 2018 and may be used if a more specific code is not available on the Podiatric Fee Schedule.

 

Cost Invoice for Fee-for-Service Pricing

 

A cost invoice is still required for HFS pricing of an item or supply provided in the office. Providers must attach the invoice to the appropriate paper claim form (HFS 2360 for physicians and APNs; HFS 1443 for podiatrists) upon submission. Claims submitted with a date of service on and after October 1, 2018 with the unlisted office supply CPT code 99070 will be rejected and will need to be resubmitted with a different HCPCS code.

 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.

 

 

Patricia R. Bellock

Director

 

 

 

 

 

Codes Added Effective October 1, 2018 to Practitioner Fee Schedule for

Items and Supplies Provided in the Office Setting

 

Code

Description

 

 

A4561

Pessary, rubber, any type

A7007

Large volume nebulizer; disposable unfilled, used w/aerosol compressor

A7015

Aerosol mask, used with DME nebulizer

A9999

Miscellaneous DME supply or accessory, not otherwise specified

B4087

Gastrostomy/jejunostomy tube

E0100

Cane, any material; adjustable or fixed with tip

E0105

Cane, any material; quad or three prong, adjustable or fixed with tip

E0112

Crutches-underarm; wood, adjustable or fixed, pair, with pads, tips, and handgrips

E0114

Crutches-underarm; other than wood, adjustable or fixed, pair, with pads, tips and handgrips

E0191

Protector-heel or elbow; each

E1399

DME, miscellaneous

L0172

Cervical collar, semi-rigid thermoplastic foam, two piece

L0174

Cervical collar, semi-rigid thermoplastic foam, two piece with thoracic extension

L1499

Spinal orthosis, not otherwise specified

L1812

Knee orthosis, elastic with joints, prefabricated, off-the-shelf

L1833

Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf

L2999

Lower extremity, orthoses, not otherwise specified

L3260

Surgical boot/shoe, each

L3334

Lift, elevation, heel, per inch

L3485

Heel; pad, removable for spur

L3650

Shoulder orthosis, figure of eight design, abduction restrainer, prefabricated, includes fitting and adjustment.

L3710

Elbow, orthosis, elastic with metal joints, prefabricated, includes fitting and adjustment

L3809

Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type

L3982

Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment

L3999

Upper limb orthosis, not otherwise specified

L4350

Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g. pneumatic, gel) prefabricated, includes fitting and adjustment

L4361

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf

L4387

Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf

L5999

Lower extremity prosthesis, not otherwise specified