Wiki Oral Administration of J3490

[Heather_Snyder]

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]

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

 

[Heather_Snyder]

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.

 

[danskangel313]

You would bill for the appropriate office visit charge. You need to make sure the diagnosis(es) are appropriate for the treatment.