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kenalog help..please respond

  1. #1
    Exclamation kenalog help..please respond
    Exam Training Packages
    I can't find this information anywhere..please help
    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. #2
    Location
    Nashville, Tennessee
    Posts
    35
    Default
    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
    Sandy Stevens, CPC, CPMA

  3. Default 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. #4
    Location
    Dover Seacoast New Hampshire
    Posts
    1,971
    Default
    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
    Pam Brooks, MHA, COC, PCS, CPC, AAPC Fellow
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  5. #5
    Default
    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. #6
    Default
    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 03:43 PM.

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