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Wiki How to Bill Methotrexate Units?

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tfrick2

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How would this be coded? :confused:

Medication: METHOTREXATE SODIUM 25 MG/ML SOLN (METHOTREXATE SODIUM)
Given? Yes
Dose: 25 mg - 1 ml
Lot #:
Injection Site: Left Deltoid
Route: Subcutaneous/Intramuscular
Given By:


I think it would be billed as J9250 x5 units, but I am being told that it should be billed with J9250 x10 units because the drug is billed by vial size (which is apparently 10ml). Wouldn't it be best to bill J9250 x5 units, and J9250-JW x5 units?
 
For single dose vials of drug you can bill for the drug given the patient and for waste. Some carriers want the waste and drug given on the same line, so it's not a one rule system when billing for drugs. You are correct in general to bill on two lines, the second line with a JW modifier. But check with each carrier to determine their preference; the JW modifier is a CMS modifier and may be recognized or allowed per payor.
 
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