Wiki How to bill J0741 CABENUVA

[RaeToll]

I have a denial for HCPCS J0741 where 600 units were billed. Medicare denied stating the information submitted does not support this many/frequency of services.

The order is for Cabotegravir/Rilpivirine 600mg/3mL - 900mg/3mL ER injection Suspension Kit 6 mL. The nurse documented a total of 6mL given. Is 600 units billed correct?

How should one dose of J0741 be billed?

 

[RaeToll]

I figured it out. Billing drug dosage sometimes confuses me. For any one else needing references for this: https://nastad.org/sites/default/files/2022-04/PDF_Cabenuva_ADAP_NASTAD_March 2022.pdf

 

[cbiglow]

Thank you for posting the answer. It was very helpful!