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J codes

  1. Question J codes
    Medical Coding Books
    Does anyone know if J codes are payable to physicians in a facility place of service?

    Thanks in advance!

  2. #2
    Dover Seacoast New Hampshire
    J codes (injectible drugs supplied by the provider) are payable in the office setting because the office has purchased the injectibles for administration to the patient. The reimbusement is to offset the practice's expense.

    Injectibles (or other medications) provided/administered to the patient in the facility are not reimbursable to the physician, since they were provided by the facility. The codes can be reimbursed (check your payment indicators in HCPCS) to the facility.

    If the provider personally administers the injectible in the facility, then a professional service, such as 20610 (Major joint injection) can be billed. Most medication administrations in the facility are provided by ancillary staff, so you'll have to be sure that this was absolutely done by your provider.

    If you are billing as a provider-based entity, there is no "office" Place of Service; and the facility will still be able to recoup the charge for the J code, not the physician.
    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

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