kimberagame
Contributor
Our clinic just started adding NDC numbers to our claims about 6 months ago, so it's new to us. We have a new coder in the clinic with more experience in NDC billing, and we are at a stalemate regarding a particular situation. Our clinic has only one version of Depo Medrol, which is 80mg/ml. If half a cc is given, I would report J1030 (40 mg of methylprednisolone) with one unit, and the NDC number with 0.5 as the quantity.
But the NDC number for any 80mg/ml version of Depo Medrol is only associated with J1040 (80 mg of methylprednisoline) on the HCPCS-NDC crosswalk. So our new coder is insisting that we have to report J1040 with a unit of 1, and the NDC number with a quantity of 0.5.
Is this correct? Do we seriously have to report, what I consider to be, an inaccurate HCPCS code, just because of the particular product our clinic buys?
We gave 40 mg of Depo Medrol. There's a HCPCS code for 40 mg of Depo Medrol. Do we really need to use the HCPCS code for 80 mg of DepoMedrol just because we gave half a ml of the 80mg/ml version, so that our NDC code matches in the crosswalk?
But the NDC number for any 80mg/ml version of Depo Medrol is only associated with J1040 (80 mg of methylprednisoline) on the HCPCS-NDC crosswalk. So our new coder is insisting that we have to report J1040 with a unit of 1, and the NDC number with a quantity of 0.5.
Is this correct? Do we seriously have to report, what I consider to be, an inaccurate HCPCS code, just because of the particular product our clinic buys?
We gave 40 mg of Depo Medrol. There's a HCPCS code for 40 mg of Depo Medrol. Do we really need to use the HCPCS code for 80 mg of DepoMedrol just because we gave half a ml of the 80mg/ml version, so that our NDC code matches in the crosswalk?