Billing for Depo Medrol J1020, J1030, J1040

[Cford101]

When billing for Depo Medrol injections do you bill for the total mg’s administered or for the vial the medication is pulled from?

example: Patient comes in for a trigger point injection-the total number of trigger points is 4, with 20mg injected into each trigger point. Would you bill for the total amount of steroid given to the patient, J1040 80mg’s; or would you bill J1020 20mg with 4 units.

 

[jonique.dietzen]

That would depend on the payor. You could code it either way.

https://coder.aapc.com/family-pract...for-the-correct-injection-code-102527-article

Jonique Dietzen, CPC, Project Manager

 

[daedolos]

If you're coding for four injections, I'd use the J1020x4.

Peace
@_*

 

[jenngar]

You have to code the vial of medication that was used.. so J1020 x4.

I know some insurance companies require the NDC# from the vial used so the code and the vial would need to match.



Jennifer Garland, CPC

 

[daedolos]

J1040

Has anyone heard of Molina denying J1040 for a invalid-deactivated-withdrawn NDC?

Peace
?_?
I can't find any literature on this. Medicare Part B ASP pdf from CMS has a value for payment allowance.

 

[rcmspt]

You have to code the vial of medication that was used.. so J1020 x4.

I know some insurance companies require the NDC# from the vial used so the code and the vial would need to match.



Jennifer Garland, CPC

So you would bill

20552
J1020 x 4

(using your scenario)