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I am running into a problem in the orthopedic office where I work, one of the managers is telling us to bill the J1040 Depro-medrol 80 mg code with 2 units. now normally we would bill 2 units if the Doc indicates he did this procedure bilaterally ,however this procedure is being done unilateral. I believe that billing 2 units is incorrect. Does anyone have any advice on this issue? My concern is if we are audited this will look like fraudulent billing....please help!!!


Tonika Rhodes,CPC
 
hi
the documentation states the doc injected the patient with 80mg depro-medrol into left knee. however we are instructed to bill the J1040 as 2 units which seems incorrect since the code itself is 80mg. billing at 2 units would increase the fee and that is incorrect. Am I wrong on this?
thanks
 
dpounders said:
Depo-Medrol is listed for 40 mgs. So in order to get paid for 80 mgs. you would use 2 units
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There is more than one Depo-Medrol code, the 40mg one is J1030. J1040 does say 80mg and should only be billed once. I mean I suppose if 160mg were used you would use 2 units, but I would think if that much were going to be used ever they would've made another code for that. Just my two cents.
 
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