Anesthesia Coding Alert

Question: What is the correct way to bill medication units during pump refills, such as J0735 (Injection, clonidine HCl, 1 mg)? Wyoming Subscriber Answer: Your first step is verifying whether the medication is compounded rather than a commercially prepared "off-the-shelf" preparation such as Duraclon, which comes in two strengths (0.1 mg/ml or 0.5 mg/ml). Example: If your provider fills the pump with 40 mg of commercially-prepared Duraclon, you would bill for either 400 ml of the 0.1 mg/ml strength or 80 ml of the 0.5 mg/ml strength. Because most implanted infusion pumps hold 20 to 40 ml, it's likely that the clonidine is being compounded at a specially made concentration so the patient can receive the correct quantity of medication for the limited pump volume. Compound change: Many Medicare contractors have policies regarding how they want you to report compounded drugs, especially those used in implanted infusion pumps. Many request [...]