Results 1 to 4 of 4

J3301 - orthopedic thread

  1. Default J3301 - orthopedic thread
    Medical Coding Books
    Hello,
    Does anyone have an accurate answer and supporting CMS web links to the proper guidelines of blling J3301? There were some previous discussions that I have reviewed in the orthopedic thread, but it still was not quite clarified. I am getting denials on this J code, but not the actual procedure code(s) 20600-20610.
    The denial explanation stated it needed a referring physician. My manager feels that it is something else beyond this. It really does not make sense that the procedure code and E/m code is being paid but not the J code, simply for a referring physician. Another issue that was raised was, is the J code bundled into the E/M code? The only thing so far I was able to find on the CMS Florida website is that effective May 2008, certain J codes including the J3301 will be denied w/o a valid NPI.
    Does anyone have any concrete supporting links?

  2. #2
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    I believe that J3301 (Kenolog) bundles with the injection

  3. #3
    Location
    Capital Coders, Columbia, SC
    Posts
    145
    Default J3301
    All of my J3301's get paid (in South Carolina). The referring physician denial is odd, though. Sometimes, their denial reasons are a little mixed up (assuming we are talking about Medicare) such as the denial, "Claim lacks info" for a bad ID #. Is it just the J3301 you are having this problem with? You may want to make certain that you are sending the correct NDC #, qualifier and measure of units with it.

  4. #4
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    The J3301 should be paid..who is the carrier (just curious)? The J3301 shouldn't be bundled in with the injection - you actually shouldn't be billing/coding and injection (90772) if there is an office visit or procedure with the J3301. The "injection" is bundled in with either the procedure performed (20605/20610 or whatever) or the office visit. Also, does the office visit have a modifier .25 on it? (it's needed due to the procedure being done), hopefully it supports and E/M with the procedure.
    in anycase, we get paid for J3301.
    well, that's my three pennies
    Donna

Similar Threads

  1. J3301
    By Ashlee Dugas in forum Ophthalmology/Optometry
    Replies: 0
    Last Post: 02-09-2015, 02:41 PM
  2. J3301 Rejection - I have a claim that is being rejected
    By aklunder in forum Medical Coding General Discussion
    Replies: 18
    Last Post: 04-11-2013, 09:16 AM
  3. J3301 - billing for injections
    By maryawinfield04 in forum Plastic Surgery
    Replies: 2
    Last Post: 06-29-2012, 12:36 PM
  4. J3301 - I have a question
    By orange10 in forum Orthopaedics
    Replies: 2
    Last Post: 12-20-2010, 04:56 PM
  5. coding J3301
    By Lcurless in forum Dermatology
    Replies: 1
    Last Post: 11-08-2010, 02:12 PM

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?

Login

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.