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J3490 & prescription drugs

  1. #1
    Location
    Johnson City, TN
    Posts
    11
    Default J3490 & prescription drugs
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    I've searched the forum and can't really find what I need.

    Practice is using J3490 for Flexeril, Lodine, phenergan gel, etc. I am reading the code to be used for “drugs that ordinarily cannot be self-administered”. I am thinking pills don't fall into this category. Of course, they don't want to hear me. Any suggestions?
    Andy CPC
    MRM
    Johnson City, TN

  2. #2
    Default
    I'm with you 100% on this one. Stocking those medications is just part of doing business, you can't charge for them in pill form. If they don't want to eat the cost then they need to quit stocking them.

    I have nothing other than the book to support this but it is pretty clear. The first page of the J codes, show them the heading.

    DRUGS ADMINISTERED OTHER THAN ORAL METHOD J0000-J9999

    It is right there in all caps and bold.

    I will add you do have the option of J8498 for antiematic drug, rectal suppository if that is the method they are giving the phenegren, but I think that is the only one you listed that comes in that form in addition to the oral pill. I think the real key to this is as you said, that can not ordinarily be self-administered.

    Good luck,

    Laura, CPC, CEMC
    Last edited by LLovett; 10-19-2009 at 11:30 AM.

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