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Dysport injection coding

  1. Default Dysport injection coding
    Medical Coding Books
    I need help. I am billing and coding a J0589 dysport with 64612 destroy facial muscle. I am using 1 unit for the destroy facial muscle and 24 units for the dysport. Blue cross keeps denying for incorrect coding. Can someone help me and tell me what I am doing Wrong. The diagnosis im using is 333.81.

  2. #2
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by riverloverjen38@yahoo.com View Post
    I need help. I am billing and coding a J0589 dysport with 64612 destroy facial muscle. I am using 1 unit for the destroy facial muscle and 24 units for the dysport. Blue cross keeps denying for incorrect coding. Can someone help me and tell me what I am doing Wrong. The diagnosis im using is 333.81.

    The correct HCPCS for Dysport is J0586; thats probably where your problem is.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  3. Default
    Sorry. That is the code im using.

  4. #4
    Location
    Greater Orlando
    Posts
    146
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    Jen,

    Are you using J0586 or J0589? Your original query mentions J0589.
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  5. #5
    Location
    Baton Rouge
    Posts
    1,239
    Default
    Quote Originally Posted by riverloverjen38@yahoo.com View Post
    Sorry. That is the code im using.
    What is the exact denial? We do this procedure often in my clinic, I'd like to try to help, if you can give more info.
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

  6. Default
    I am billing with diagnosis code 333.81 and the J0586, 60 units which is whole vial and then with JW modifier. Then with 64612 code for desrto facial muscle. I put in box 19 the units that were destroyed.
    We actually used 120 units and the vial is 300 units.

    Help!!!

  7. #7
    Default
    Quote Originally Posted by riverloverjen38@yahoo.com View Post
    I am billing with diagnosis code 333.81 and the J0586, 60 units which is whole vial and then with JW modifier. Then with 64612 code for desrto facial muscle. I put in box 19 the units that were destroyed.
    We actually used 120 units and the vial is 300 units.

    Help!!!
    Hi Jen. Because you say that the reason for denial is "incorrect coding", I offer the following suggestions:
    1-Make sure that you are billing with type of service (TOS) 9 for the drug, and type of service 2 for the procedure.
    2-Make sure your state's BCBS plan is requiring that you split out the wasted drug. BCBS of MI does not require it, so we bill for the entire vial if the unused portion is not used for another patient.
    3-J0586 is per 5 units, so you are correct that there are 60 billing units per 300 unit vial. Therefore, if you gave 120 units, the billing units would be 24. The wasted units would be 36. This would go on a separate billing line with the modifier JW. Your claim would look like this:
    CPT MODIFIER QTY
    Line 1: J0586 24
    Line 2: J0586 JW 36
    Line 3: 64612 1

    Hope this helps! Feel free to email me if you need more help. I have been billing for chemodenervation for many years and am happy to help in any way I can.
    ~Chris

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