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HCPCS Codes Change for Albuterol, Levalbuterol Claims

BALTIMORE--Effective July 1, Medicare will no longer pay claims for albuterol and levalbuterol (Xopenex) inhalation solutions under the J7611, J7612, J7613 and J7614 HCPCS codes, CMS said in a July Quarterly Update.

Instead, the agency said, new codes Q4093 and Q4094 will be payable for claims with dates of service on or after July 1. The new payment rate has not been announced.

In addition, a new code for Reclast will be effective July 1, CMS said. Only the 5 mg/100 ml bottle should be billed under the new code, Q4095.

Earlier this year, CMS issued a revised policy that denies coverage for compounded inhalation solutions on the basis that they are medically unnecessary. That policy change also takes effect July 1.

For more information, click here for a Medlearn Matters article: http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5645.pdf

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