Wiki J3301 Units

[lnsds08]

My question is the number of units should be used and can we code J3301 more than once with 20610. How would this be coded including units

• Triamcinolone-40, 40mg/1mL : 60 mg (Dose No:1) (Route: Intraarticular) on Knee, Left (Pain in left knee)
• Triamcinolone-40, 40mg/1mL : 60 mg (Dose No:2) (Route: Intraarticular) on Knee, Right (Pain in right knee)

I was told to code J3301 x 3 on separate lines with 4 units each.

 

[ZubairHameed]

For Medicare, the injection would typically be billed as follows:

20610 — 50 modifier — M25.561, M25.562
J3301 x12 — M25.561, M25.562

The 50 modifier (bilateral procedure) is appropriate for Medicare and bundles the bilateral joint injections into one line item.


However, for commercial insurances, some may prefer separate claim lines using RT/LT modifiers instead of the 50 modifier. In that case, you'd code it like this:


20610 — RT — M25.561
J3301 x6 — M25.561
20610 — LT — M25.562
J3301 x6 — M25.562

Note: Always verify payer-specific guidelines — some commercial plans will reject the 50 modifier and want distinct laterality with RT/LT, while Medicare accepts and often prefers the bilateral 50 modifier format.

 

[lnsds08]

So, it is allowed to put 6 units J3301?

 

[ZubairHameed]

So, it is allowed to put 6 units J3301?

You can put as many units as MUE allows, and MUE in this case is 16 SO you can put units up to 16.

 

[ole16]

J3301 has a Medically Unlikely Edit (MUE) of 16 units per date of service. That means CMS (and many commercial payers) will flag the claim if more than 16 units are billed in one day... unless there's strong documentation and possibly a medical review. So yes, you can report multiple units of J3301 on one line as long as the total is 16 or fewer (which yours is). No need to break it out over multiple lines... doing that can actually cause denials or confuse payers.