How to code Kenalog injections


Kailua Kona, HI
Best answers
I am coding the injection using 11900, then the drug J3301. J3301 is 10mg, so convert that to cc's. Dr. uses .2cc and there are 1000mg in 1cc, is coding 20 units correct? :confused:
I've had several conversations about this with my providers and the MA's here. At the end of the day we were all confused. I finally told them that the code was in MG and they needed to tell me how many MG's they gave the patient. I'm not clinical so I think the provider should be giving me that info. It seems to be working well so far. I hope that helps.

it depends on the concentration of the medication... in mg/ml... you can convert mg/ml to mg/cc as 1 ml = 1 cc. If your medication is at a concentration of 10 mg/ml, then you have 10 mg in 1 cc. you cannot directly convert mg to cc. you need more information from the drug.
The Kenalog strength that is usually used for intralesional injections is 10 mg/ml. Since 1ml is 1cc if they are using 0.2cc that is less than 1 ml so I would code that as 1 unit (can't code less than 1) For our dermatologists it is extremely rare for them to use over 1 cc of kenalog for intradermal lesional injections without needing the 11901 code. If you coded for 20 units (cc's) that would be a red flag to me, I would definitely look into what strength kenalog they are using and how they are using it. Intralesional injections are small amounts injected in various lesions. If one of my doctor's marks 4 units for J3301 then I know it is more likely that they are doing an IM injection of kenalog for an allergic reaction which is a different code altogether.

Hope this helps,

Amber Newcomb, CPC-A
coder for a dermatology practice
I agree

I agree with the above posts, you need the strength of the solution mg/mL; be aware sometimes the provider will use a stronger solution and will dilute it to desired solution prior to injection (i.e. 20mg/mL diluted to 10mg/mL TAC). Multiply by #cc injected to get mg of TAC. [X mg/mL * #cc = X mg TAC / 10 = # units]. For less than 10mg it's my understanding that the TAC used is included in the 11900 injection code allowable (although I have seen some offices bill for 0.5-0.9mg with 1 unit, put #mg in the description)

Hope that helps,
Mallory, CPC, CPCD
Lead coder Dermatology office
Documentation Error from Our Office

My Dermatology office uses 10mg/ml or 20mg/ml kenalog for intralesional injection.
So, our office uses cpt code 11900 with documentation on the relational fields with
following information.

ndc of the kenalog with dashes 11 numerical characters.
KENALOG ACETONIDE 10MG in text field.
1.00 unit
Dollar amounts/unit.(It is always dollar amount of one unit).
1.00 in quanitity field
ml in unit field.

Did I make any obvious mistakes.

Rudolph Reindeer