For J3315 INJECTION, TRIPTORELIN PAMOATE, 3.75 MG (e.g., Trelstar®):
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For J9202 GOSERELIN ACETATE IMPLANT, PER 3.6 MG (e.g., Zoladex®; note that Zoladex® Implant 10.8 mg, which is billed using 3 units of J9202, is covered only for 185 Malignant Neoplasm of Prostate):
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Tuesday, August 3, 2010
billing CPT J3315 , J9202 with allowed diagnosis
J3315 and J9202 with relavent ICDs
Labels:
CPT / HCPCS,
J CODE
Medicare physician fee schedule - Quick overview
Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download

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