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Thread: Depo provera new j1050

  1. #1

    Default Depo provera new j1050

    AAPC: CPC Promo
    I understand that the J1055 Depo Provera 150mg inj. for contraceptive care has been deleted from HCPCS this year. The new code to use is J1050 1mg, my question is, do we use 150 in the unit amount when submitting the claim? Can anyone tell me what they have used so far?

    Thanks,

    Connie

  2. #2

    Default

    we have run across this same issue.....im not having any luck finding the proper way to bill with the new code J1050

  3. #3
    Join Date
    Apr 2007
    Location
    Ft. Wayne, Indiana
    Posts
    5

    Default

    we are having the same issue...the new HCPCS book is contradicting itself regarding the code...we think it is an error that they deleted the J1055 but still trying to figure out what to do...we hate to sit on the billing but we can't justify charging 150 units either!!

  4. #4

    Default

    I have contacted pfizer to see what they have to say as I told them we would not be able to carry their product if we cannot bill it out. they are checking on it. First they told me to call the ama.

  5. #5

    Default

    Quote Originally Posted by NanaT View Post
    we are having the same issue...the new HCPCS book is contradicting itself regarding the code...we think it is an error that they deleted the J1055 but still trying to figure out what to do...we hate to sit on the billing but we can't justify charging 150 units either!!
    We are in the same boat. Our OB/GYN does large amounts of Depo Provera shots daily, we can't justify the quadrupled pricing for 150 mg? Waiting for more research and info on what to do??? Help!

  6. #6

    Default J1050 for depo

    We have taken the NDC number, figured our price per unit from the average wholesale price and are billing it out at 150 units. Not sure yet if we are going to get denials, since we have only started sending them out.
    Please let me know if anyone figures out another way. Thanks.

  7. #7

    Default

    WE can bill 1unit for up to 150 mg of depo provera

  8. #8

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    there is a place in our pm/ehr to put that it is 1 MG but there are 150 NDC units.

  9. #9

    Default

    Yes, this is becoming a huge problem. I have instructed our coding department to hold all Depo billing until this is resolved. This does not seem like it will be a problem that is going to be solved quickly!

  10. #10

    Default

    I agree, this Depo and units/mgs change is quickly becoming a huge problem. We are holding them also, good idea! Thanks.

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