We are receiving remittances from Medicare and other payors denying payment on HCPCS code J0810 as not a valid code. We are reporting the E&M with a modifier 25 along with the drug code and are unsure of the remark code. Can you help us?

HCPCS code J0810 is no longer a valid Medicare HCPCS code thus the denial is appropriate. . In order to report the drug code in addition to joint injection, trigger point injection, or any other surgical injection, the physician must identify the specific drug and dosage. There are specific HCPCS codes for drugs such as kenalog, celestone, triamcinolone, or other glucocorticoids. The Medicare Fee Schedule contains a list of all CPT and HCPCS codes and is available for download at http://www.cms.hhs.gov/providers/pufdownload/rvudown.asp .
You may also purchase a 2005 HCPCS reference book with a list of all current drug and supply codes from the AMA.

Mary LeGrand, RN, MA, CCS-P, CPC
KarenZupko & Associates, Inc.