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Thread: is J3490 billable with cpt 20550?

  1. #11
    Join Date
    Apr 2007

    Talking Anytime(-"

    AAPC: Back to School
    Quote Originally Posted by vermonter View Post
    Thank you for all your help. It is appreciated.
    Your welcome, its just what I do 24/7 & the J codes have been an obstacle so thought best to pass on to other coders/billers to hopefully make it a little easier to get those paid.

    Melinda T.

  2. #12


    Quote Originally Posted by vermonter View Post
    Is j3490 billable with cpt 20550 or is it bundled?
    It has a n1 asc payment indicator (packaged procedure/item; no separate payment made) in Hcpcs 2008
    I totally agree with Melindathi. Do your homework real quick to see if there is a more specific HCPCS for the Unlisted "J" code, if there is, then use it if not to report J3490 drug name, dosage and NDC# on filed 19 of the CMS1500 should be documented, regardless if the claim is hardcopy or electronic, your system should allow you to key this info in.

    There is no indication in the CPT book about reporting the solultion separate from 20550 nor does it indicate if it is inclusive, so I would try appealing the denial.

  3. #13
    Join Date
    Apr 2007

    Default CCI edits

    Pretty sure it is a bundeled service (But you can check CCI's on the medicare site which shows 20550 and all codes that are considered a bundeled service when billed with that code)

    What medicine are you billing for with a Trigger Point? Since all the trigger point medicine I know about now have a specific J code, so that could be where you are going wrong and why you are being denied also.

    Last suggestion is check Modifiers, since another possibility is that you are missing a required modifer for 20550 is billed with certain medications.

    If one of my coders knows more will write again but off the top of my head thats what I personally know(-"

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