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J2175 50 mg, but description is per 100

  1. #1
    Location
    Greenville, NC
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    Default J2175 50 mg, but description is per 100
    Medical Coding Books
    OK....so, J2175 is per 100 in the HCPCS book, but patients routinely get 50 mg (while some do get 100 mg).

    Since the description is "per 100" vs. "up to 100" how do I bill this? I have done some research and getting very conflicting solutions - what do those that are on here do/suggest?

    Thanks,
    Hunter Smith, CPC

  2. #2
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    Tacoma, WA
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    1,087
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    Quote Originally Posted by hsmith67 View Post
    OK....so, J2175 is per 100 in the HCPCS book, but patients routinely get 50 mg (while some do get 100 mg).

    Since the description is "per 100" vs. "up to 100" how do I bill this? I have done some research and getting very conflicting solutions - what do those that are on here do/suggest?

    Thanks,
    Hunter Smith, CPC
    Is the other 50mg wasted on those that don't get 100mg? If so, you bill the 100mg and document that 50mg was given and 50mg wasted.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
    Location
    Greenville, NC
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    The demerol comes in 50 mg ampuls. So, 1 full ampul is used or 2 full ampuls are used. There is apparently no J code for using just one 50 mg single use ampul.

  4. #4
    Location
    Tacoma, WA
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    1,087
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    Quote Originally Posted by hsmith67 View Post
    The demerol comes in 50 mg ampuls. So, 1 full ampul is used or 2 full ampuls are used. There is apparently no J code for using just one 50 mg single use ampul.
    In this case then I would use J3490 and put the info on the claim for the med. If there is no code that is the only thing you can really do.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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