Wiki Code for Fentanyl 20mg for pump/NEED ASAP

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consultingbykristin

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Physician reprogrammed and refilled pump with Fentanyl 1mg/ml x20ml=20mg. that's how he wrote it. Would the correct code for the Fentanyl be J1810 x20 or J3010 or is it another HCPCS altogether?

Need help ASAP...please!

Thanks in advance
 
J1810
Injection, droperidol and fentanyl citrate, up to 2 ml ampule
Lay Description
Per the FDA, this drug is no longer available in the United States.

Above I saw on Optum Encoder, for J1810. Below I copy and pasted a portion of response by marvelh from a thread on found on this forum describing the method of determining the units for fentanyl.


https://www.aapc.com/memberarea/forums/showthread.php?t=49682&highlight=Fentanyl

marvelh
If the fentanyl was commercially prepared, though pretty unlikely, it would have it's own valid NDC number and you would need to know the total amount of Fentanyl that was used for the refill. This can also be calculated but you would need to know the strength of the fentanyl and volume that as injected. For example, if the Fentanyl was 0.5 mg (50 mcg) per ml (strength) and a total of 20 ml was injected (common implanted pump volume) a full refill would be 20 x 0.5 or 10 mg. In this example if you were billing the commercially prepared Fentanyl and not a compounded version, you would bill need to bill 100 units of J3010 (10 x 0.1)
 
More than likely the Fentanyl is compounded to that strength. From what I found the standard concentration of Fentanyl is 50 mcg/ml or 0.05 mg/ml which is very different from the 1 mg/ml that was indicated. 1mg/ml is equivalent to 1000 mcg/ml!

I would check to see if it was compounded, if so then you would need to report it as per payer requirements, which is often J3490, but some payers want J7799 and other payers may have others. Best to check.
 
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