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Thread: J1040 Code

  1. #1

    Smile J1040 Code

    AAPC: Back to School

    I have a claim that was billed with an office visit 99213 -25 with cpt code 96372 and cpt code J1040.

    The ins co paid for the ov and cpt code 96372, but not the J1040. It states that J1040 is not a covered service.

    Is there any way I can appeal this?

    Thank you in advance for your help.

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Did it state why it was non-covered? Diagnosis? I haven't experienced any reimbursement issues for Depo-medrol.

  3. #3

    Default j1040 code

    No, just says on eob that it's not a covered service. I was looking in LCD and NCCI in National Government Service and I couldn't find any information.

  4. #4
    Join Date
    Apr 2007


    Not sure what state you are in, but here in Iowa we have to use NDC codes. Iowa medicaid does not cover the ndc for J1040, so we use J1030 at 2 units, and do not have any problems. Just a thought for you, but it may not be your problem. Good luck!

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