Wiki J1380 Injection estradiol valerate up to 10 mg

[Christine Patterson]

Could someone please help me to understand the special coverage instructions for J1380.

Does this mean that if we give up to 20 mg we use one unit of J1380? or do we use two units with this code?

The physician in our office uses up to 20mg. Therefore I have been using one unit of J1380 feeling I had coded correctly until today when the office manager called and questioned it

End of day sarcasm. I was handed a code book about 10 years ago and started to code claims. I never knew I would have to know so many regulations, drugs, abbreviations, procedures, diagnosis codes, and have excellent A&P skills. I just do not know why I don't have a quick answer for every question asked of me.

Thank you for your help. If I am way off base I apologize and will learn from your responses.

 

[yadavarvindkum]

Could someone please help me to understand the special coverage instructions for J1380.

Does this mean that if we give up to 20 mg we use one unit of J1380? or do we use two units with this code?

The physician in our office uses up to 20mg. Therefore I have been using one unit of J1380 feeling I had coded correctly until today when the office manager called and questioned it

End of day sarcasm. I was handed a code book about 10 years ago and started to code claims. I never knew I would have to know so many regulations, drugs, abbreviations, procedures, diagnosis codes, and have excellent A&P skills. I just do not know why I don't have a quick answer for every question asked of me.

Thank you for your help. If I am way off base I apologize and will learn from your responses.

Christine,

As per J1380 (Injection, estradiol valerate, up to 10 mg) description, up to 10 mg is considered as ONE unit. I would code 2 units of J1380 if physician administers 20 mg. The maximum allowed limit for J1380 is 3 Units.

Thank you,
Arvind

 

[Christine Patterson]

Thank you.

I learn daily and always appreciate anyone who is kind enough to respond to my question.

I will correct my notes and bill two units in the future.

Thank you again for your response.

Greatly appreciated.

chris