# Injections-that is using J1040



## sueolson (Jun 14, 2010)

We have a clinic that is using J1040 which is an 80 mg methylprednisolone acetate injection, but they only give 40 mgs.  They do not have the J1030 vials which are 40 mg doses in house.  My question is that I want to bill 0.5 units and am having some issues.  Does anyone else bill this way?
Thanks,
Sue


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## Herbie Lorona (Jun 14, 2010)

You can't bill a 0.5 in the units.


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## cmcgarry (Jun 14, 2010)

Herbie Loroña said:


> You can't bill a 0.5 in the units.



Are these multi-dose vials or single-dose vials?  If they are multi-dose, you would then bill the J1030 with one unit, as they are going to use the rest of the vial for someone else.  If, however, they are single-dose, you would bill for the entire vial, as the rest is wasted (also one unit).

If, however, your office routinely does only 40 mg, and the vials they order are single dose, they really should be ordering the 40 mg vials, rather than continually billing insurance for the wastage.

Most of the depo our offices use comes in multi-dose vials; we then bill whatever was really given (20, 30, 40, etc.)


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## Priiis1 (Jul 18, 2019)

cmcgarry said:


> Are these multi-dose vials or single-dose vials?  If they are multi-dose, you would then bill the J1030 with one unit, as they are going to use the rest of the vial for someone else.  If, however, they are single-dose, you would bill for the entire vial, as the rest is wasted (also one unit).
> 
> If, however, your office routinely does only 40 mg, and the vials they order are single dose, they really should be ordering the 40 mg vials, rather than continually billing insurance for the wastage.
> 
> Most of the depo our offices use comes in multi-dose vials; we then bill whatever was really given (20, 30, 40, etc.)


But what about the NDC code?  Wouldn't you have to use a NDC code that is associated with the Depo 40mg?


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## trarut (Jul 19, 2019)

sueolson said:


> We have a clinic that is using J1040 which is an 80 mg methylprednisolone acetate injection, but they only give 40 mgs.  They do not have the J1030 vials which are 40 mg doses in house.  My question is that I want to bill 0.5 units and am having some issues.  Does anyone else bill this way?



If these are 80 mg single-dose vials - and it sounds like they are if you're wanting to bill 0.5 units for 40 mg of an 80 mg vial - you should be billing 1 unit for the injection since the remaining 40 mg is waste and cannot be used on another patient.  

And as cmcgarry pointed out, your pharmacy should be stocking 40 mg vials if that is dose most commonly used by your clinic.


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## thomas7331 (Jul 19, 2019)

Priiis1 said:


> But what about the NDC code?  Wouldn't you have to use a NDC code that is associated with the Depo 40mg?



I believe that the same NDC codes are associated with all of the HCPCS codes that could be drawn from that vial, so this shouldn't be a problem.


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