# LCD Guidelines for J3420 -- UNITS



## SSMcElyea-Vironet

I am having a lot of problems lately getting J3420 paid.  Here's how we'll bill it:

J3420 x2 units
96372

Medicare keeps giving us a rejection of CO151.  I finally got some info out of a Medicare rep that it has to do with the Units billed.  I noticed that when we bill J3420 x1 unit.. it gets paid.  We're billing the correct DX code too.  I checked LCD for that.  281.0.  BUT, the LCD doesn't give me anymore information than that on really how many units the pt can receive.  I've read on a coding site one time say limit is once per month...I get that...need info on the UNITS.

CAN SOMEONE PLEASE HELP ME WITH THIS?  If anyone has a link to anything that can tell me Units that is allowed and so forth.  I know we can get this paid.  Just want to know how!  Furthermore, if we can only bill for 1 unit.  I need the info to share with our physicians.  

HELP!

Thanks!

Sarah, CPC


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## SueTeal

The J3420 code in HCPCS says 'up to 1000 mcg'. How much is the patient being given? I think you might find in the majority of the cases that you do not go over 1000 mcg. Therefore 1 unit should be sufficient. Does this make sense?


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