# Kenalog units



## mcdream (Aug 10, 2021)

Hi all,
How many units of J3301 is:
4ml of kenalog (40mg/ml)?
Tia


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## thomas7331 (Aug 10, 2021)

mcdream said:


> Hi all,
> How many units of J3301 is:
> 4ml of kenalog (40mg/ml)?
> Tia


4 ml X 40 mg/ml = 160 mg dosage given. 

Per the HCPCS code description, J3301 is 10 mg per unit, so you would bill 16 units.


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## SharonCollachi (Aug 10, 2021)

Are you sure you're using 4 milliliters?  Average adult dosing is 40 milligrams (one milliliter) or less per joint or multiple trigger points.


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## thomas7331 (Aug 11, 2021)

SharonCollachi said:


> Are you sure you're using 4 milliliters?  Average adult dosing is 40 milligrams (one milliliter) or less per joint or multiple trigger points.


For local injections that may be true, but for systemic use, the dosage can be higher.  I've worked with a provider who uses up to 200 mg.  The Medicare MUE is set at 16 units, so 160 mg is acceptable and would be reimbursed.


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## mcdream (Sep 27, 2021)

thomas7331 said:


> 4 ml X 40 mg/ml = 160 mg dosage given.
> 
> Per the HCPCS code description, J3301 is 10 mg per unit, so you would bill 16 units.





thomas7331 said:


> Kenalog comes in 10mg per cc & also 40mg per cc





thomas7331 said:


> 4 ml X 40 mg/ml = 160 mg dosage given.
> 
> Per the HCPCS code description, J3301 is 10 mg per unit, so you would bill 16 units.





thomas7331 said:


> Kenalog comes in 10mg per cc & also 40mg per cc


1ml of kenalog 40mg/ml = J3301x4
Does 1ml of 10mg kenalog also equal J3301x4?
TIA


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## SharonCollachi (Sep 27, 2021)

The billing units are based on milligrams, not milliliters.  If one ml of 10 mg kenalog is what you are using, then you are using one unit.  One unit = 10 mg.

So the answer is no, it is not 4 units, it is one unit.


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## mcdream (Sep 27, 2021)

SharonCollachi said:


> The billing units are based on milligrams, not milliliters.  If one ml of 10 mg kenalog is what you are using, then you are using one unit.  One unit = 10 mg.
> 
> So the answer is no, it is not 4 units, it is one unit.


ok so 1ml of 10mg kenalog = J3301x1
but
1ml of kenalog 40mg/ml = J3301x4?
TIA


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## thomas7331 (Sep 27, 2021)

mcdream said:


> ok so 1ml of 10mg kenalog = J3301x1
> but
> 1ml of kenalog 40mg/ml = J3301x4?
> TIA


1 ml of what strength?  ml and mg are two different measurements - you can't convert one to the other without knowing the strength of the mixture.  If it's 1 ml of 10 mg/ml, then it would be 1 unit, but if it's a different strength then it could be a different dose and different units.


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## mcdream (Sep 27, 2021)

thomas7331 said:


> 1 ml of what strength?  ml and mg are two different measurements - you can't convert one to the other without knowing the strength of the mixture.  If it's 1 ml of 10 mg/ml, then it would be 1 unit, but if it's a different strength then it could be a different dose and different units.



Strength being 10mg/ml vs. 40mg/ml

So if it's 1ml of 40mg/ml then it would be 4 units (J3301x4)?
TIA


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## thomas7331 (Sep 27, 2021)

mcdream said:


> Strength being 10mg/ml vs. 40mg/ml
> 
> So if it's 1ml of 40mg/ml then it would be 4 units (J3301x4)?
> TIA


Yes, if there are 40 mg in each ml, then administering 1 ml will give the patient a 40 mg dose.  You code based on the dose given, not on the volume.  So if 40 mg was given, that's 4 units of J3301.


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## mcdream (Sep 27, 2021)

thomas7331 said:


> Yes, if there are 40 mg in each ml, then administering 1 ml will give the patient a 40 mg dose.  You code based on the dose given, not on the volume.  So if 40 mg was given, that's 4 units of J3301.


I think I've got it, can we do another example?
3ml of 10mg/ml = J3301x3
3ml of 40mg/ml = J3301x12
TIA


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## thomas7331 (Sep 28, 2021)

mcdream said:


> I think I've got it, can we do another example?
> 3ml of 10mg/ml = J3301x3
> 3ml of 40mg/ml = J3301x12
> TIA


Yes, those are correct.


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## mcdream (Oct 1, 2021)

thomas7331 said:


> Yes, those are correct.


And when you have less than 1ml:
.4ml kenalog (10mg/ml) = J3301x1?
.4ml kenalog (40mg/ml) = J3301x2?
TIA


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## thomas7331 (Oct 1, 2021)

mcdream said:


> And when you have less than 1ml:
> .4ml kenalog (10mg/ml) = J3301x1?
> .4ml kenalog (40mg/ml) = J3301x2?
> TIA


Yes, correct.  You cannot report a fraction of a unit with the HCPCS codes, so you would bill one unit for anything less than a unit that was given.  But the NDC and dosage information that goes onto the claim along with the drug code should have the exact dosage information in the event that the payer requires it.


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## mcdream (Oct 1, 2021)

thomas7331 said:


> Yes, correct.  You cannot report a fraction of a unit with the HCPCS codes, so you would bill one unit for anything less than a unit that was given.  But the NDC and dosage information that goes onto the claim along with the drug code should have the exact dosage information in the event that the payer requires it.


So 1ml of kenalog 40mg/ml has 4 units.  
Does that mean .4ml of kenalog 40mg/ml = J3301x1 or J3301x2 (.4ml nearly half of 1ml of Kenalog 40mg/ml)?
I appreciate your time & patience


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## thomas7331 (Oct 1, 2021)

mcdream said:


> So 1ml of kenalog 40mg/ml has 4 units.
> Does that mean .4ml of kenalog 40mg/ml = J3301x1 or J3301x2 (.4ml nearly half of 1ml of Kenalog 40mg/ml)?
> I appreciate your time & patience


.4 ml of 40 mg/ml is 16 mg, which would translate to 1.6 units of J3301.  Since you cannot bill a fraction of a unit, you would have to round up to one for unit for any amounts above 10 mg.  In other words, bill 2 units in this case.


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## amy.key86@yahoo.com (Nov 17, 2021)

What role does the NDC play?  is it reported as informational only, or will the value of the NDC override the value of the J3301?  in other words, will the reimbursement be for the J code units or for the value of the NDC?


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