# correct billing for J1040



## TRHODES (Feb 21, 2013)

I am running into a problem in the orthopedic office where I work,  one of the managers is telling us to bill the J1040 Depro-medrol 80 mg code with 2 units.  now normally we would bill 2 units if the Doc indicates he did this procedure bilaterally ,however this procedure is being done unilateral. I believe that billing 2 units is incorrect. Does anyone have any advice on this issue?  My concern is if we are audited this will look like fraudulent billing....please help!!!


Tonika Rhodes,CPC


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## mitchellde (Feb 21, 2013)

well what does the documentation state was given?


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## TRHODES (Feb 25, 2013)

hi
the documentation states the doc injected the patient with 80mg depro-medrol into left knee.  however we are instructed to bill the J1040 as 2 units which seems incorrect since the code itself is 80mg.  billing at 2 units would increase the fee and that is incorrect.  Am I wrong on this?
thanks


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## dpounders (Mar 28, 2013)

Depo-Medrol is listed for 40 mgs.  So in order to get paid for 80 mgs.  you would use 2 units


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## aaron.lucas (Mar 28, 2013)

dpounders said:


> Depo-Medrol is listed for 40 mgs.  So in order to get paid for 80 mgs.  you would use 2 units




There is more than one Depo-Medrol code, the 40mg one is J1030.  J1040 does say 80mg and should only be billed once.  I mean I suppose if 160mg were used you would use 2 units, but I would think if that much were going to be used ever they would've made another code for that.  Just my two cents.


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