Wiki Units of billing for J1030

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bethb

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Good morning! I am stumped, would anyone be able to help me figure this one out?

Our office gave a patient 60 mg of J1030. The first vial, which was a 40 mg single-use vial was adminstered. (1 unit billed) To acheive a 60 mg dose to the patient, a second vial, same as the first vial (40 mg single-use vial) was used, but only 20 mg of it was used. The remaining was discarded.

My first idea is to bill the J1030 with 2 units. And we cannot bill for the discarded portion.

Can anyone help me with this one? I greatly appreciate any thoughts or suggestions.

Thank you all for your time!

Beth B.
 
You should probably code it as x1 unit of J1030 (Injection, methylprednisolone acetate, 40mg) + x1 unit of J1020 ((Injection, methylprednisolone acetate, 20mg).

That seems more like what you actually gave. Hope that helps!

Sam :)
 
J1030

I would bill that as J1020 Quantity 3 and on another line bill J1020 Quantity 1 with modifier JW for discarded drugs so you get paid for that too.

You can also bill it with J1020 Quantity 1 and J 1030 quantity one and anther J1020 quantity 1 with modifier JW. I think either way would be fine.

You said you only carry J1030 but I think you can use the J1020 code quantity 2 even if you have the 40milligrams. Like for some other drugs that there is only one code available to use then you bill it with more quantity.

I hope it helps :)
 
I didn't think we could bill for waste. I am just unsure if J1030 could be billed with 2 units, even though not all of the second vial, was used. 60 mg was administered to the patient. 2 vials used, each vial is 40 mg (that is all the office had in supply was the 40 mg vials-no 20 mg vials were available). Can 2 units be used for J1030 given the circumstance?
 
You're right.

I know you could only bill waste on single dose vials. That's right! I still bill the waste. Some insurance pays for it and most don't if they don't pay it then I just write it off.
 
How about if the doctor uses 2 bottles (1cc per bottle) of the 40mg/cc? Can I code for J1030x2 or would J1040 work?

Peace
?_?
Please advise.
 
thelma said:
This should be coded J1020 with 3 units.
Click to expand...

Are you looking at the original post from years ago or the one above yours asking about the 2x 40mg vials.

daedolos said:
How about if the doctor uses 2 bottles (1cc per bottle) of the 40mg/cc? Can I code for J1030x2 or would J1040 work?

Peace
?_?
Please advise.
Click to expand...


I can't find anything written on it. I'd say use the highest dosage code and use the smaller codes to make up the difference. J1040x1 accounts for the full dose of 80 MG.
 
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