J1020 J1030 Depomedrol

suki_26

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This seems like a very easy question but after over thinking this now we are not so sure.

J1020 = 20mg
J1030 = 40mg

the question is what about billing for 60mg?

It seemed simple, bill a J1020 and then a J1030 with just 1 admin code. after some research we realized medically those are different strengths and has nothing to do with quantity. Soo since in the coding book there are only options for 20, 40 or 80 and there is no way to bill 1.5 units........? Should we just be billing the code for the 40 and absorbing the cost for the rest?

It seems the book should specify 1ml of 20mg....1ml of 40mg..... etc. ( In this particular case we have doctors giving 1.5ml of 40mg)
many of the other codes for injections in the book will specify x "up to" y. This code does not.

Any help would be greatly appreciated.
 

KMCFADYEN

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J1040 is for 80 mg

“If the drug dose used in the care of a patient is not a multiple of the HCPCS code dosage descriptor, the provider rounds to the next highest unit based on the HCPCS long descriptor for the code in order to report the dose provided..."
 

suki_26

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Im not seeing that, where did you find that so I can have it to show to the Dr's

thank you for your reply.
 
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