Wiki J3301 billing

[akaeb]

when a pt is in the office and recieves a Kenalog injection and is given 40 mg we use the J3301 hcpc code and then we normally change the quantity to 4. But when looking at the hcpc book with the code it says use this code for kenalog 40 does this mean that we should be leaving the quantity as 1 instead of changing it to 4 or should we be changing the quantity to 4 if 40 mg is given?

thanks!!

 

[daedolos]

It's 10mg per dose on J3301. If you documented use of 40 mg then it's J3301 x 4.

Peace
@_*

 

[TxDerm]

Kenalog

I understand the process of billing J3301 X quanity of 4 when you use 40mg, but what if we only used 2.5mg of the 10mg and on the claim the NDC description will ask for the dosage amount would we say 2.5mg or 10mg for the dosage?

 

[daedolos]

My understanding is that it comes in 10mg dosages and any use up to 10 mg would be billed as J3301 x 1.

Peace
@_*

 

[ellzeycoding]

For the NDC code units and description (in shaded area above J-code) you include dosage administered (not units billed).

 

[daedolos]

Does that mean that the payor prorates the injectable?

Peace
?_?

 

[ellzeycoding]

No, they pay per unit billed. If you inject less than what's specified per unit, you always round up. There is no way to bill for 1/2 or 1/4 unit of a J-code. Always round up.

They don't pay based on the NDC description in the shaded area