HCPCS code L0636: Lumbar-sacral orthosis, custom fabricated
HCPCS code L0636 falls under the L-series of the CMS HCPCS Level II code set, which covers orthotic procedures and devices. The official long descriptor for L0636 reads: Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame and panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T-9 vertebra, […]
HCPCS code K0553: CGM supply allowance, deletion, and replacement codes
HCPCS code K0553 described a monthly supply allowance for a therapeutic continuous glucose monitor (CGM) device that was non-adjunctive and non-implanted. The code bundled all supplies and accessories into a single monthly billing unit, with one unit of service equaling one month of supply. Field Detail HCPCS Code K0553 Long Description Supply allowance for therapeutic […]
HCPCS code J1438: Injection, etanercept, 25 mg billing guide
Most rheumatology and dermatology practices that administer Enbrel in-office submit claims under one code. HCPCS code J1438, officially described as “Injection, etanercept, 25 mg; code may be used for Medicare when drug administered under the direct supervision of a physician; not for use when drug is self-administered,” is that code. The self-administration restriction is not […]
HCPCS Code J2800: Methocarbamol injection billing guide
J2800 bills one unit per methocarbamol administration up to 10 ml. Put the NDC in field 24A with a covered diagnosis.
HCPCS code J3090: Injection, tedizolid phosphate, 1 mg (Sivextro)
J3090 bills tedizolid phosphate at 1 unit per mg, so a 200 mg Sivextro dose is 200 units, with NDC 67919-0040-02 on the claim.
HCPCS Code J2941: Injection, somatropin, 1 mg billing guide
J2941 bills somatropin at 1 mg per unit. Part B pays only when your staff gives the injection, otherwise the dose falls to Part D.
HCPCS code T1001: Nursing assessment/evaluation billing guide
T1001 covers an RN nursing assessment for Medicaid. Most denials come from a missing state modifier, a non-RN provider, or thin notes.
HCPCS code S0316: Disease management program follow-up/reassessment
HCPCS code S0316 is the billing code for disease management program follow-up and reassessment services. Report it when a patient already enrolled in a structured program attends a visit to review progress, adjust goals, or reassess their care plan. It belongs to HCPCS Level II, the code system maintained by the Centers for Medicare and […]
HCPCS code L0974: TLSO full corset billing guide
HCPCS code L0974 describes a thoracic-lumbar-sacral orthosis (TLSO), full corset. It is a Level II HCPCS code maintained by CMS, the Centers for Medicare and Medicaid Services. Suppliers use it to bill corset-style spinal braces that span the thoracic, lumbar, and sacral spine. The code sits in the orthotic procedures and devices section of HCPCS […]
HCPCS code K0744: Wound suction dressing billing guide
HCPCS code K0744 is an absorptive wound dressing for use with a suction pump. The full descriptor adds home model, portable, and a pad size of 16 square inches or less. CMS added the code on July 1, 2011. The descriptor matters more than usual here. K0744 is the smallest of three dressing sizes, K0744 […]