1. The Complete Procedure Coding Book By Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA Chapter 14 Coding Medical Supplies, DME, etc. Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved McGraw Hill/Irwin

2. Learning Outcomes Interpret correctly the rules and guidelines for coding medical supplies. Apply the instructions for properly coding medical supplies with HCPCS Level II codes. Report the most accurate HCPCS Level II codes for DME. 14-2

3. Learning Outcomes Determine the correct generic or brand name of drug. Utilize the guidelines for coding transportation services. Assign the best code for transportation services. 14-3

4. Introduction HCPCS Level II codes are used to report the supply of items to the patient for use at home for self-administered health care, and drugs administered by health care professionals. 14-4

5. A Codes & B Codes The medical supplies listed in these sections of HCPCS Level II are for patient’s use at home. The supplies used in the course of treating a patient in a health care facility are, for the most part, included in the CPT code for the procedure or service. 14-5

6. Durable Medical Equipment Commonly called DME Can withstand repeated use Primarily used for medical purposes Used in the patient’s home Would not be used if the individual was not ill or injured 14-6

7. DMEPOS DMEPOS dealers -- Durable Medical Equipment, Prosthetic, and Orthotic Supplies Submit claims to the CMS assigned DMERC --Durable Medical Equipment Regional Carrier 14-7

8. E Codes Primary section for coding the provision of DME. Always check the alphabetic index for codes listed in other sections that may be more appropriate. 14-8

9. Pharmaceuticals Used only for those drugs administered by a health care professional Not used for medications self-administered by the patient 14-9

10. Pharmaceuticals Methods of administering medications: IA Intra-arterial IV Intravenous IM Intramuscular IT Intrathecal SC Subcutaneous INH Inhaled ORAL Orally OTH Other routes VAR Various routes 14-10

11. Pharmaceuticals Generic names Brand or trade names Listed in the : Alphabetic index Appendix 1 Table of Drugs J codes section 14-11

12. Pharmaceuticals Appendix 1 - Table of Drugs Drugs listed in alphabetic order Shown in dosages Listed by route of administration 14-12

13. Pharmaceuticals Not all drugs are listed in the alphabetic index. Be aware of the quantity specifications in the code description. 14-13

14. Transportation Ground ambulances Air ambulances –Helicopter –Plane (fixed wing) Non-emergency transportation Additional costs and fees –Mileage –Waiting times 14-14

15. Transportation 1.What type of vehicle was used? 2.What type of services were provided? 3.Did the ambulance have to wait? 4.How many miles? 5.Were extra personnel needed? 14-15

16. Transportation Origin/Destination Modifiers Waiting times are billed in 30 minute increments Ambulance billing indicators provide more information about the reason for the transport 14-16

17. Chapter Summary HCPCS Level II codes are used to report the supply of items. Understanding the complexities of this additional set of codes opens many additional employment opportunities. 14-17