1. Networker
Posts
52
How would you bill:

o.6 cc of Kenalog 40? which converts to 24mg.

do you bill it as 3 units or 2 units.

I am having a disagreement with the billing manager who says we should bill as 2 units,
I say 3 units.

Can anyone give me the link to varify this information?

2. J3301 triamcinolone acetonide, (Kenalog-10, Kenalog-40) per 10 mg
If your bottle says Kenalog 40 =40 mg/ml

If you use 0.25 cc 10 mg/40 mg = 1 Unit
If you use 0.5 cc 20 mg/40 mg = 2 Units
If you use 0.75 cc 30 mg/40 mg = 3 Units
If you use 1.0 cc 40 mg/40 mg = 4 Units

3. Guest
Posts
120
Billing Medications
HI,

It sounds like you're asking how to bill when the dose is not a multiple of the HCPCS code dosage. Here is the CMS medication billing instruction in those instances.
To answer your question directly, you are right. It should be a unit of 3.

Drugs are billed in multiples of the dosage specified in the HCPCS code long descriptor. If the drug dose used in the care of a patient is not a multiple of the HCPCS code dosage descriptor, the provider rounds to the next highest unit based on the HCPCS long descriptor for the code in order to report the dose provided.
If the full dosage provided is less than the dosage for the HCPCS code descriptor specifying the minimum dosage for the drug, the provider reports one unit of the HCPCS code for the minimum dosage amount.

Melanie

4. Melanie is correct. You can't convert volume (cc) to weight (mg).

You need to first determine the billable unit per HCPCS, and then determine the same unit per the administration.

This often requires checking the box that the meds come in...they will report the weight of the medication, as part of the volume of the solution that is administered.

Anyone remember junior high science class?!! LOLOL

5. Location
Dallas
Posts
12
Sorry to say but I believe you are all incorrect. If you have Kenalog 40mg per ml and you only administer 0.6ml then the units would be 1. Kenalog 40mg/ml = 1 unit.

6. New AAPC Fellow
Posts
9
The code is per 10mg, so it would be 3 units if 1ml = 40mg and you gave .6ml.
Last edited by jesfriday; 04-26-2011 at 02:43 PM.

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