Wiki Dysport injection coding

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I need help. I am billing and coding a J0589 dysport with 64612 destroy facial muscle. I am using 1 unit for the destroy facial muscle and 24 units for the dysport. Blue cross keeps denying for incorrect coding. Can someone help me and tell me what I am doing Wrong. The diagnosis im using is 333.81.
 
I need help. I am billing and coding a J0589 dysport with 64612 destroy facial muscle. I am using 1 unit for the destroy facial muscle and 24 units for the dysport. Blue cross keeps denying for incorrect coding. Can someone help me and tell me what I am doing Wrong. The diagnosis im using is 333.81.


The correct HCPCS for Dysport is J0586; thats probably where your problem is. :D
 
I am billing with diagnosis code 333.81 and the J0586, 60 units which is whole vial and then with JW modifier. Then with 64612 code for desrto facial muscle. I put in box 19 the units that were destroyed.
We actually used 120 units and the vial is 300 units.

Help!!!
 
I am billing with diagnosis code 333.81 and the J0586, 60 units which is whole vial and then with JW modifier. Then with 64612 code for desrto facial muscle. I put in box 19 the units that were destroyed.
We actually used 120 units and the vial is 300 units.

Help!!!
Hi Jen. Because you say that the reason for denial is "incorrect coding", I offer the following suggestions:
1-Make sure that you are billing with type of service (TOS) 9 for the drug, and type of service 2 for the procedure.
2-Make sure your state's BCBS plan is requiring that you split out the wasted drug. BCBS of MI does not require it, so we bill for the entire vial if the unused portion is not used for another patient.
3-J0586 is per 5 units, so you are correct that there are 60 billing units per 300 unit vial. Therefore, if you gave 120 units, the billing units would be 24. The wasted units would be 36. This would go on a separate billing line with the modifier JW. Your claim would look like this:
CPT MODIFIER QTY
Line 1: J0586 24
Line 2: J0586 JW 36
Line 3: 64612 1

Hope this helps! Feel free to email me if you need more help. I have been billing for chemodenervation for many years and am happy to help in any way I can.
~Chris
 
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