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Process for supplying invoice amount on certain HCPCS codes (Prior to January 1, 2023)
Last Modified: 2/23/2023
Location: FL, PR, USVI
Business: Part B
We recently revised this article to educate on billing certain contractor-priced codes, including skin substitutes, radiopharmaceuticals, and more, billed with dates of service prior to January 1, 2023.
For instructions regarding how to bill these services with dates of service on or after January 1, 2023, click here. The HCPCS codes included in this initiative are listed below as well as the effective dates. This process is applicable for these codes on claims with dates of service on the corresponding effective dates.
You must proactively enter the invoice information on your incoming claim.
• Obtain the total invoice cost for the patient and service. You must report the amount from the invoice that is applicable for the patient and service on the claim; you aren’t reporting the retail amount or amount you charge for the service.
• Enter the invoice amount on block 19 of the CMS-1500 paper claim form or its electronic equivalent of Loop 2400 Segment NTE02 in the following format (including cents):
• INV. $00.00
Claim example
First Coast will reject any claims without the invoice amount or information about the cost associated with the code(s) back to you for correction.
Dates of service on or after December 29, 2018:
Q4103, Q4122, Q4124, Q4125, Q4126, Q4127, Q4128, Q4130, Q4134, Q4135, Q4136, Q4137, Q4138, Q4140, Q4141, Q4142, Q4143, Q4146, Q4147, Q4150, Q4151, Q4152, Q4154, Q4157, Q4158, Q4159, Q4160, Q4161, Q4163, Q4164 (for claims with dates of service from December 29, 2018-December 31, 2021), Q4165, Q4166, Q4167, Q4170, Q4175, Q4176, Q4178, Q4179, Q4180, Q4181, Q4182
Dates of service on or after January 1, 2019:
Q4183, Q4184, Q4188, Q4190 (for claims with dates of service prior to February 11, 2022), Q4191, Q4193, Q4197, Q4198, Q4200, Q4201, Q4203, Q4204
Dates of service on or after October 1, 2019:
Q4205, Q4209, Q4210, Q4211, Q4214, Q4216, Q4217, Q4218, Q4219, Q4220, Q4221, Q4222
Dates of service on or after July 1, 2020:
Q4115, Q4227, Q4228, Q4229, Q4235, Q4236, Q4237, Q4238, Q4239, Q4247, Q4248
Dates of service on or after October 1, 2020:
Q4250, Q4254, Q4255
Dates of service on or after January 1, 2021:
Q4100, Q4101, Q4102, Q4107, Q4116, Q4118, Q4121, Q4173, Q4186
Dates of service on or after January 1, 2022:
Q4252, A2001, A2002, A2004, A2005, A2006, A2007, A2008, A2009, A2010
Dates of service on or after August 8, 2022:
A2011, A2012, A2013
Dates of service on or after October 1, 2022:
A2014, A2015, A2016, A2017, A2018
Dates of service on or after December 29, 2018:
A4642, A9501, A9503, A9504, A9508, A9509, A9512, A9516, A9526, A9527, A9528, A9529, A9530, A9531, A9532, A9536, A9538, A9539, A9540, A9541, A9542, A9544, A9545, A9546, A9550, A9553, A9557, A9559, A9563, A9564, A9566, A9567, A9569, A9570, A9571, A9572, A9580, A9587, A9588, A9599
Dates of service on or after January 1, 2021:
A9502, A9507, A9582, A9591
Dates of service on or after January 1, 2022:
A9590
Dates of service on or after July 1, 2022:
A9596
Dates of service on or after August 1, 2019:
Q2039
Dates of service on or after January 1, 2021:
P9010, P9011, P9012, P9016, P9017, P9019, P9020, P9021, P9022, P9023, P9031, P9032, P9033, P9034, P9035, P9036, P9037, P9038, P9039, P9040, P9044, P9050, P9051, P9052, P9053, P9054, P9055, P9056, P9057, P9058, P9059, P9060, 86850, 86860, 86870, 86880, 86885, 86886, 86890, 86891, 86900, 86901, 86902, 86904, 86905, 86906, 86921, 86922, 86923, 86927, 86930, 86931, 86932, 86945, 86950, 86960, 86965, 86970, 86971, 86972, 86975, 86976, 86977, 86978, 86985
Dates of service on or after August 8, 2022:
Q9951
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.