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bwallis
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The AWP for Testopel is ____ /pellet.
$96.25
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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
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The NDC number is not required on Testopel Medicare/Medicaid claims.
False
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ICD9 codes are alphaneumeric codes given to:
- every diagnosis, description of symptoms and cause of death
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Although typical medicare reimbursement for medications that fall under a medical benefit is ASP+6%, Testopel has been reimbursed at _________ across MAC's.
invoice
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Both J and S codes are examples of ____
HCPCS codes
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For hypogonadism several different codes are frequently used including:
257.2 other testicular hypofunction
257.8 other testicular dysfunction
257.9 Unspecified
True
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Following adequate anesthesia, ____ is used to make a 4mm incision.
11 blade scalpel
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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
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To begin Testopel insertion the patient should be in what position?
Lateral jack knife or fetal position
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What is a J code?
J codes are used for injectable or implantable drugs that ordinarily can't be easily self administered.
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Post Testopel insertion, patients may go swimming after 24 hours
False - 72 hours
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Once the trocar has been advanced, the sharp stylet is removed and the Testopel pellets are placed in the trocar well using forceps.
True
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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
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ASP refers to:
Average Selling Price to all purchasers in US
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What is the J code assigned for Testopel?
J3490
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What is the CPT code for Testopel?
11980
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Once the initial incision is made, a _____ is introduced at a _____ angle to reach the subcutaneous tissue.
trocar, 30 degrees
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What is an S code?
S codes are temporary national codes that are used for non-medicare payers
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The S code for Testopel?
S0189
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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
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Testopel can be treated as a medical or pharmacy benefit.
True
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CPT codes are numbers that are assigned to:
- medical, surgical and diagnostic services provided by a medical practitioner
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The WAC for Testopel (the amount doctors pay before any volume discount) is ____/pellet.
$77
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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
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