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) that was non-adjunctive and non-implanted. The code bundled every supply and accessory into a single monthly billing unit, where one unit of service equaled one month of supply. CMS discontinued K0553 effective December 31, 2022. Field Detail HCPCS Code K0553 […]
HCPCS code J1438: Injection, etanercept, 25 mg billing guide
HCPCS code J1438 is a billable J-code for an injection of etanercept, 25 mg, the biologic sold as Enbrel. Its official descriptor limits it to Medicare claims where a physician administers the drug under direct supervision. It cannot be billed when the patient self-administers at home. Etanercept is the generic name and Enbrel is the […]
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 […]
HCPCS code J0970: Deleted estradiol valerate injection code
J0970 was deleted in 2011. Bill estradiol valerate as J1380, one unit per 10 mg, capped at 3 units a day by Medicare’s MUE.