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Multidose Vial Billing

aadair

Contributor
Messages
19
Location
Glenville, NY
Best answers
0
I have recently taken on a rheumatologist to do billing for. He does many bursa injections so I am using 20600, 20605 and 20610. He injects Depomedrol 80 mg and Xylocaine. I would like to be able to get him reimbursed for the Depomedrol J1040 but he uses a multidose vial. He states it is a 15 cc vial but he may only use 1/4 1/3 1/5 of the vial on one pt. How do I properly bill quantity used and billed amount to the insurances?:confused:
 
Messages
359
Location
Malone
Best answers
0
Depo Medrol

For Depo Medrol Injections I code the medication for the total amount injected per mg. For instance if 80 mg depo medrol was injected in major joint 20610 and j1040.
 

aadair

Contributor
Messages
19
Location
Glenville, NY
Best answers
0
Thank you for your response but I'm still confused as to the quantity to bill. If the Dr gives say 2 cc or 3 cc of Depo 80 mg, what do I put in as the quantity billed. Some reading I have done states you bill quantity (1) if you use the whole vial? Since he is using multidose, I'm not sure what to bill as my quantity. Are there any instructions out there regarding injectable billing? Thank you for any assistance you can offer!:)
 
Messages
359
Location
Malone
Best answers
0
Depo Medrol

HCPCS codes identify a specific dosage or definition of the billing unit. Any dosage up to and including the amount specified represents one billing unit. If the dosage is greater than the dosage listed, increase the number of units accordingly by whole numbers. Example: J0120 Injection, Tetracycline, up to 250 mg. One unit represents an injection of 250 mg or less; more than 250 mg up to 500 mg equals 2 units, etc.

Heather
 
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