Primary Care Coding Alert

Question: Our practice is receiving many requests for the new contraceptive injection Lunelle. How should I code for this drug?

Texas Subscriber  
Answer: Lunelle, which was recently approved by the FDA as a contraceptive injection, does not have a HCPCS code yet. You should use J3490 (unclassified drugs) to report the drug itself and 90782 (therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) for the administration. You also need to submit the amount and dosage of the drug. Specify Lunelle on the claim form and include its national drug code: 0009-3484.
 
Some patients come in with their own medication. In this case, charge for the administration only, 90782. If the encounter also has an E/M component, report the appropriate level (99201-99215) with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).