Cutaquig SCIg | Diagnostic & Billing Codes for Providers

Diagnostic and billing codes for cutaquig

Codes provided here contain information necessary to bill payers:

  • International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)
    • ICD-10-CM diagnosis codes that may apply include: D80.1, D80.7, D82.0, D81.9, D80.5, D80.0, D80.3, D80.2, D80.4, D83.9
    • Note – Diagnosis codes are provided for reference only. Selection and documentation of an appropriate diagnosis code are the responsibility of the patient’s healthcare provider.
  • Healthcare Common Procedure Coding System (HCPCS) codes
    • Cutaquig has the following HCPS Codes for commercial insurance and Medicare:
      J1551 COMMERCIALUse CODE J1551 for most commercially paid claims and may be used for billing and reimbursement with all private physician offices and hospital outpatient centers
      J1551-JB MEDICAREUse CODE J1551-JB for claims paid by the Medicare Part B
      Durable Medical Equipment (DME) benefit

      -JB Modifier for Medicare Billing Medicare requires the addition of Modifier -JB to the HCPCS code for cutaquig (J1551) to confirm subcutaneous administration. Example: J7799-JB.

      JB should also be added to the HCPCS code (when the route of administration is subcutaneous) for the covered infusion pumps (E0779, E0781) following the modifier to indicate whether the pump is being rented (RR) or purchased (NU). Example: E0779-RR-JB or E0781-NU-JB.

      Either an E0779 or an E0781 infusion pump is covered. If a different pump is used, it will be denied as not reasonable and necessary

      • Additional information required by most payers on claim forms:
        • Branded/generic name
        • Strength
        • Dosage administered
        • Route of administration
        • National Drug Code (NDC)
      • Some payers may also request:
        • Package insert
        • FDA approval letter
        • Documentation to support medical necessity
        • Drug purchase invoice
  • National Drug Code (NDC) numbers
    • Vial NDC numbers: 68982-810-81, 68982-810-83, 68982-810-85, 68982-810-86
    • Carton NDC numbers: 68982-810-01, 68982-810-03, 68982-810-05, 68982-810-06
  • Current Procedural Terminology (CPT) codes

CPT, HCPCS, and ICD-10-CM codes provided are based on AMA or CMS guidelines.

Coding information is provided for reference only. The treating healthcare provider(s) is responsible for certifying and documenting the correct and appropriate coding of services to obtain reimbursement. Because government and other third-party payer coding requirements change periodically, please verify current coding requirements directly with the payer being billed.

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