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Wiki J0129 Injection, abatacept, 10 mg

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gdominguez

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Is there a limit when billing J0129? We are receiving denials stating this code can only be billed 1 time per month. I cannot find any documentation to support this. Any help would be appreciated. Thank you.
 
I didn't see anything in HCPCS other than the usual dosage, but remembered hearing that it is usually once per month. So, I checked on WEB MD - here's what they say: "After the first dose, this medication is usually given again 2 weeks and 4 weeks later, then every 4 weeks or as directed by your doctor."

The insurance has probably built an edit based on that recommendation.

Hope this helps!
 
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