ICD9 codes are designations given to the diseases that doctors treat and CPT codes are designations given to procedures they conduct in their offices.
True
The NDC number is not required on Testopel Medicare/Medicaid claims.
False
ICD9 codes are alphaneumeric codes given to:
every diagnosis, description of symptoms and cause of death
Although typical medicare reimbursement for medications that fall under a medical benefit is ASP+6%, Testopel has been reimbursed at _________ across MAC's.
invoice
Both J and S codes are examples of ____
HCPCS codes
For hypogonadism several different codes are frequently used including:
257.2 other testicular hypofunction
257.8 other testicular dysfunction
257.9 Unspecified
True
Following adequate anesthesia, ____ is used to make a 4mm incision.
11 blade scalpel
Once the area on the upper outer quadrant of the posterior gluteal region is appropriately marked, what should be used to anesthesize the area?
2% lidocaine with epi
To begin Testopel insertion the patient should be in what position?
Lateral jack knife or fetal position
What is a J code?
J codes are used for injectable or implantable drugs that ordinarily can't be easily self administered.
Post Testopel insertion, patients may go swimming after 24 hours
False - 72 hours
Once the trocar has been advanced, the sharp stylet is removed and the Testopel pellets are placed in the trocar well using forceps.
True
Once the Testopel pellets are advanced with the stylet and the trocar is removed, the incision is closed with dissolvable sutures.
False - Steri strips and Tegaderm
ASP refers to:
Average Selling Price to all purchasers in US
What is the J code assigned for Testopel?
J3490
What is the CPT code for Testopel?
11980
Once the initial incision is made, a _____ is introduced at a _____ angle to reach the subcutaneous tissue.
trocar, 30 degrees
What is an S code?
S codes are temporary national codes that are used for non-medicare payers
The S code for Testopel?
S0189
It is possible for 2 physicians to be reimbursed different amounts for a Testopel insertion under the CPT code 11980 by the same insurance company.
True
Testopel can be treated as a medical or pharmacy benefit.
True
CPT codes are numbers that are assigned to:
medical, surgical and diagnostic services provided by a medical practitioner
The WAC for Testopel (the amount doctors pay before any volume discount) is ____/pellet.
$77
Examples of services/items that would be covered under a medical benefit where your physician bills the insurance company directly are:
in office procedures
supplies
nurse time/Dr time
injectable drugs administered under dr supervision
