Wiki Propofol- j3490/j2704

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mchamberlain

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Has anyone experienced any issues/denials or requests for corrected J code for propofol?
January 1 there was a newly issued code J2704 for Injection Propofol 10mg. We have continued using J3490 and have just received our first denial from 1 payer for incorrect code.

Has anyone had any feedback from any payers, while using the J3490 and/or J2704? If we change this across the board, are we going to run into payers that aren't using this code yet?

Just wanted some thoughts. Thanks!
 
If there is a HCPCS code that accurately represents the drug being administered that is ready for use then that code should be reported instead of the unlisted code. I don't know of any guidance that supports choosing to still report an unlisted code.
 
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