Tuesday, July 27, 2010

How to Bill J Codes Correctly by the “UNITS” with example

Example#1: J1100-Dexamethasone, 1 mg Your bottle says 4 mg/ml

If you use 0.25 cc (1 mg) = 1 Unit
If you use 0.5 cc (2 mg) = 2 Units
If you use 0.75 cc (3 mg) = 3 Units
If you use 1.0 cc (4 mg) = 4 Units

Example#2 J1030 methylprednisolone acetate, 40 mg (Depo-Medrol)
Your bottle says 40 mg/ml

If you use 0.25 cc 10 mg = 1 Unit
If you use 0.5 cc 20 mg = 1 Unit
(J1020=methylprednisolone acetate, 20 mg )
If you use 0.75 cc 30 mg = 1 Unit
If you use 1.0 cc 40 mg = 1 Unit

Example#3 J3301 triamcinolone acetonide, (Kenalog-10, Kenalog-40) per 10 mg
Your bottle says Kenalog 40 =40 mg/ml

If you use 0.25 cc 10 mg/40 mg = 1 Unit
If you use 0.5 cc 20 mg/40 mg = 2 Units
If you use 0.75 cc 30 mg/40 mg = 3 Units
If you use 1.0 cc 40 mg/40 mg = 4 Units

Example#4 J0702 betamethasone acetate and betamethasone phosphate, per 3 mg
(Celestone Soluspan 6 mg/ml)

If you use 0.25 cc 1.5 mg/6 mg = 1 Unit
If you use 0.5 cc 3 mg/6 mg = 1 Unit
If you use 0.75 cc 4.5 mg/6 mg = 1 Unit
If you use 1.0 cc 6 mg/6 mg = 2 Units

2 comments:

Anonymous said...

for J3301 if injection given 1cc is equal to 40mg agreed ..but what about J3302 injection how many units are billable if 1cc given?

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Anonymous said...

I'm looking at the directions for J0702 and want to know where I can verify this...everything else I'm coming across appears to say 1 unit is per ml, which would only be 5 per vial rather than 10, I believe.

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Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
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* Office visits;
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Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
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1) Relative Value Units (RVU)
2) Conversion Factor (CF)
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[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
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