J0610

[AZ_coder]

Hello everyone;

Pt was given calcium 1 gm. I believe the code is J0610, which is per 10 ml.

How do I convert this in order to bill the correct units.

The charge was posted as 100 units and denied by Medicare as incorrect units. The billing company wants to bill 20 units (Medicare only allows 15 units). Our pharmacy tech states there is 1 gm of calcium in a 10 ml bottle. This sounds like we should be billing 1 unit. Our office manager states this should be billed as 10 units (10 ml convert to 10mg x 10 to reach 1 gm of medication).

I'm really confused and could really use some advice!

 

[AZ_coder]

Hello everyone;

Pt was given calcium 1 gm. I believe the code is J0610, which is per 10 ml.

How do I convert this in order to bill the correct units.

The charge was posted as 100 units and denied by Medicare as incorrect units. The billing company wants to bill 20 units (Medicare only allows 15 units). Our pharmacy tech states there is 1 gm of calcium in a 10 ml bottle. This sounds like we should be billing 1 unit. Our office manager states this should be billed as 10 units (10 ml convert to 10mg x 10 to reach 1 gm of medication).

I'm really confused and could really use some advice!

Hey! I think I got it!

There is 1 gm of medicine (weight) per 10 ml bottle (liquid). So, I believe it should be J0610 X 1 unit. Sound right?

 

[kendalllc]

Yes that is correct. If you were to bill 10 units, as your office manager suggested, then that would mean that you would be billing for 100 ml or 10 gm. Also, not sure if you are aware but on the Palmetto GBA website you can do a search for- Drugs and Biologicals: Maximum Allowed Units, and you will be able to find a complete list of specific J-codes and the number of units that Medicare will accept. It's a great little tool to have on hand!

Kendall