Question New BCG code

Jessim929

Guru
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Hi -

With the new code for BCG instillations beginning 7/1/19, am I correct in assuming that if a patient gets a half dose, it would be reported as J9031 0.5 units? Does anyone know if CMS is good with this?
 

thomas7331

True Blue
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You can't report a HCPCS code with a fraction of a unit. Guidelines are that fractional units of drugs should be rounded up to the next whole number.
 
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So did everyone figure out that the new BCG code is J9030? Does this have 50mg per vial? And does anyone use the JW modifier?
 
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I have been researching the update to J9030, replacing J9031; Medicare is paying $0.54 per claim for J9030 without adding any modifiers or unit amounts. Can someone help me figure out how to code a full vial (50mg) dose of BCG treatment? Simple J9030 does not seem to work
 
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