AAPC - Back to school
Results 1 to 6 of 6

Thread: J0881

  1. #1

    Default J0881

    AAPC: Back to School
    I am having trouble getting paid for this code, J0881. The doctor is billing this with an office visit only....can someone help me code this correctly and bill it so that I can get paid for the drug.
    Thank you.

  2. #2

    Default DX on J0881

    Are you using the appropriate DX per the LCD?

  3. #3


    Are you using EC or EA modifier?

  4. #4

    Default DX and EA

    I am using modifier EA. AND I am using 285.22, 185 and V58.11 for dx.
    Finance Analyst

  5. #5
    Join Date
    Apr 2007
    Grand Rapids, MI


    Chemo induced anemia requires 285.3 not 285.22. They cannot get chemo for neoplasm related anemia.

  6. #6
    Join Date
    Apr 2007
    Columbia, MO


    First V58.11 is a first only dx and is used for the encounter for the chemo.
    Also you might be missing info in box 19 per the following:
    Hematocrit or Hemoglobin Reporting
    Effective January 1, 2008, claims for the following must report the most recent hematocrit or hemoglobin
    1. All claims for the administration of an ESA (HCPCS J0881, J0882, J0885, J0886 and Q4081).
    2. All claims for the administration of a Part B anti-anemia drug that is not self-administered
    (other than ESAs) used in the treatment of cancer. (HCPCS codes J1751 and J1752 deleted
    effective 4/1/08, HCPCS code Q4098 replaced J1751 and J1752 effective 4/1/08, J1756, and
    The hematocrit or hemoglobin level should be reported in Item 19 of the Form CMS-1500. The test results
    shall be entered as follows: TR= test results (slash), R1=hemoglobin, or R2=hematocrit (slash), and the
    most current numeric test result figure up to 3 numerics and a decimal point[xx.x]).
    Example for hemoglobin tests: TR/R1/9.0:
    Example for Hematocrit tests: TR/R2/27.0:
    An you need an administration code, not an office visit if the reason for the encounter is for the drug. If not then the ov with a 25 modifier and the injection admin.
    Also per the coding guidelines:
    Code 285.22, Anemia in neoplastic disease, and code 285.3, Antineoplastic chemotherapy induced anemia, may both be assigned if anemia in neoplastic disease and anemia due to antineoplastic chemotherapy are both documented.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. ESA billing-J0881
    By uhlerclarem in forum Medicare Regulations
    Replies: 1
    Last Post: 03-25-2010, 02:12 PM
  2. code J0881
    By nowings1224 in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 08-05-2009, 08:39 AM
  3. Aranesp J0881
    By JBJ in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 10-21-2008, 07:06 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.