Wiki J1040 for Hand Surgeon

[Mjohnstone]

I am a bit confused at what is the correct way to bill J1040. The Hand Surgeon I work for prefers to use Depo-Medrol at the 80mg amount because then she injects less into the smaller joints of the hand making the injection more tolerable for the patient. She typically injects .25ml. How do I bill for this or should I even bill for it? I have seen information stating that I should still bill for 1ml and I have seen where I should bill a lesser Jcode that fits the mgs/ml. My understanding is the lesser Jcodes have a different NDC code attached to them so the code from the bottle we are using would not match the Jcode if I billed a lesser code.
Thank you for your help.

 

[Pam Warren]

You have to determine how much weight (mg) of the Depo-Medrol in within that 0.25 ml. administered. So for example, if there's 80 mg. Depo-Medrol per 1ml (volume of injectible), at 0.25 ml, you're only injecting 20 mg. You'll have to deterimine that and do the math. Depo is billed by mg, not by ml. Rather than to overreport the dosage, I'd still use the NDC code for the 80 mg, so that the correct product is identified.