ICD9 codes

ICD9 codes describe medical or psychiatric procedures performed by physicians and other health providers. The ICD9 codes were developed by the Health Care Financing Administration (now CMS) to assist in the assignment of reimbursement amounts to providers by Medicare carriers. A growing number of managed care and other insurance companies, however, base their reimbursements on the ICD9 codes.

Since the early 1970s, CMS (formerly HCFA) has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the ICD9 codes and to try to determine accurate reimbursement amounts for each code. Two committees within the AMA work on ICD9 codes issues: the CPT Committee, which updates the definitions of the ICD9 codes, and the RUC (Relative Value Update Committee), which recommends reimbursement values to the CMS (formerly HCFA). The definitions and values are based on data collected by medical societies on the going rate of services described in the ICD9 codes.

The timely, accurate reference provided by ReimbursementCodes.com allows MCOs and providers to accurately price claims. This results in:

More rapid claims processing.
Faster reimbursement for services rendered.
Fewer rejected claims.
Fewer calls to provider relations.
Improved provider relations.
More accurate revenue forecasts.

The ReimbursementCodes.com database is a component of the R.J. Health Systems Reimbursement Codes Pricing Guide, a comprehensive, accurate, single source reference for the current pricing of the CMS (formerly HCFA)) established J-codes for medications administered in the provider's office, clinic or home health agency.

Each J-code is priced in the billable unit to correspond to the CMS (formerly HCFA) established definition for each medication and does not include the charges that may be associated with administration.

ReimbursementCodes.com Database Features

Features of ReimbursementCodes.com include:

Listing of all established J-codes with corresponding descriptions as established by CMS.
AWP*, in billable units, for each J-code description.
AWP*-5%, in billable units corresponding to each J-code description. This is in accordance with Medicare reimbursement policy implemented January 1, 1998.
Ability to query by:
- J-code
- Drug name (brand or generic)
Examples of how to bill using a CMS 1500 form when:
- There is an established J-code for the drug.
- There is no established J-code for the drug.
- The provider does not supply the drug
Listing of new products, which are J-code eligible.

Disclaimer:

*AWP- The average wholesale price, for each J-code, is determined from prices published by First Data Bank, Red Book or the specific drug manufacturer utilizing calculation criteria as specified by CMS (formerly HCFA).

The J-code Pricing Guide is to be used for informational purpose only. No liability is assumed with respect to accuracy of codes, prices or data herein, due to either clerical or typographical error. All prices shown, descriptions of J-codes, and all other matters herein are subject to revision. Users of the J-code Pricing Guide should consult their legal advisor or health care consultant about claims to be filed for these products. No responsibility is assumed.

ICD9 Codes Updated Monthly
The Reimbursement-Codes.com database is updated monthly. Prices for Reimbursement Codes and ICD9 codes are updated at the close of business on the last day of the month reflecting price changes through the 15th of the month.

medical coding | medical billing | icd 9 codes | hcpcs codes