J3301, JZ bilateral denial

[drsmith1999@gmail.com]

I am getting denials from Medicare for duplicate service. I am new to rheumatology and I am uncertain how to proceed. The claims are billed out with 20610.50, J3301.JZ, J3301.JZ. Any advice will be appreciated.
Thanks in advance!

 

[amyjph]

What was the total amount of Kenalog injected? You wouldn't put the J code on two lines, you would total it on one line for the total units. That's why it shows a duplicate.
Instances where the J code is on two lines if in the scenario of drug wastage for single use vials.

 

[drsmith1999@gmail.com]

40 units each each knee.

 

[drsmith1999@gmail.com]

What was the total amount of Kenalog injected? You wouldn't put the J code on two lines, you would total it on one line for the total units. That's why it shows a duplicate.
Instances where the J code is on two lines if in the scenario of drug wastage for single use vials.

40 mg/ml each knee.

 

[ahrx13]

40 mg/ml each knee.

I would bill 8 units of J3301-JZ for the 80 mg total, on one claim line. The injection CPT code with the bilateral modifier is going to be what shows that it was injected in both knees.

 

[amyjph]

Agree with Abigail. You always have to look at the description of the J code to see what the dosage is. The units are added for the total number of units according to the description and dosage. It is not 1:1.
There can be some exceptions.

 

[drsmith1999@gmail.com]

I would bill 8 units of J3301-JZ for the 80 mg total, on one claim line. The injection CPT code with the bilateral modifier is going to be what shows that it was injected in both knees.

Thank you so much!

 

[drsmith1999@gmail.com]

I would bill 8 units of J3301-JZ for the 80 mg total, on one claim line. The injection CPT code with the bilateral modifier is going to be what shows that it was injected in both knees.

Thank you. I appreciate your help with this!