Oral Administration of J3490

Messages
3
Location
Tooele, UT
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0
Is anyone else having problems billing out the Administration for the J340 (suboxone)? The only answer I'm coming up with is "there is a more appropriate code to use" but after hrs searching I can't find anything other than H0033.

Any tips, advice or help is GREATLY appreciated!!
 

jonique.dietzen

Networker
Messages
60
Location
Chehalis, WA
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0
I believe that you are using the wrong code for Suboxone. J3490 is for unclassified drug. Suboxone has it's own codes.

J0575 - Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine
J0572 - Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
J0573 - Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 3.1 to 6 mg
J0574 - Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine

I am not aware of a code for the oral administration of drugs other than vaccines. 99211 may be appropriate for the administration depending on the level of documentation in the patient's chart.

Jonique Dietzen, CPC
 
Messages
3
Location
Tooele, UT
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0
buprenorphine

You are right we were using the incorrect code, we are now using J0571 we know it comes in 2 or 8 mg and it is billed in 1 mg increments however we are still not getting paid for this. I was wondering if it's because our referring physician is a family practice or because we need special licensing to do subutex and buprenorphine. Does anyone know? We are losing a lot of money with these claims not paying.
 
Messages
810
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0
You would bill for the appropriate office visit charge. You need to make sure the diagnosis(es) are appropriate for the treatment.
 
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