Wiki J2795 med coding

[sarthur]

Could someone help me with the cc-mg conversion? My doctors are now using Ropivicaine and I am trying to get it set up in our system correctly per unit. For example, the doctor injected 1 cc of 0.5% ropivacaine as part of a procedure. The bottle is 150mg/30ml. I can't seem to wrap my head around how to determine units for billing as well as how to determine my price per unit charge amount. The ASP amount Medicare is listing is 0.077. I know Medicare doesn't cover "caine" drugs as a rule of thumb, but I wanted to try it with our other payers to establish if any of them would cover it.
Any help would be greatly appreciated!!

 

[mhstrauss]

Could someone help me with the cc-mg conversion? My doctors are now using Ropivicaine and I am trying to get it set up in our system correctly per unit. For example, the doctor injected 1 cc of 0.5% ropivacaine as part of a procedure. The bottle is 150mg/30ml. I can't seem to wrap my head around how to determine units for billing as well as how to determine my price per unit charge amount. The ASP amount Medicare is listing is 0.077. I know Medicare doesn't cover "caine" drugs as a rule of thumb, but I wanted to try it with our other payers to establish if any of them would cover it.
Any help would be greatly appreciated!!

Ok, so the HCPCS description of J2795 is 1mg.

150mg/30mL = 5mg/1mL (just divided the num and denom by 30 to simplify the fraction)

1 mL = 1 cc (basic dosage conversion...5 cc = 1 teaspoon)

If 1 cc was injected, this equals 1 mL; this is 5mg, which is 5 units based on the HCPCS description.


Does that make sense?