Anesthesia Coding Alert

Question: How many units of J3301 are included in 4 mL of Kenalog? I’m stumped because the descriptor lists 10 mg as one unit but doesn’t mention milliliters.

Delaware Subscriber

Answer: The correct answer to your question depends on the strength of the Kenalog mixture that your provider uses. As you noted, the descriptor for J3301 (Injection, triamcinolone acetonide, not otherwise specified, 10 mg) designates 10 mg for each unit of service. However, you cannot assign units until you know the strength of the dose your provider administered.

Kenalog comes in two mixtures: 10 mg/mL and 40 mg/mL. If your provider is using the 10 mg/mL dosage, then 4 mL administered would be J3301x4. But if the patient is receiving 4 mL of Kenalog in the 40 mg/mL strength, then you would document J3301x16.

Example: Your provider administers a 1.5 mL dose of Kenalog to a patient using the 40 mg/mL mixture of the drug. You would bill this service with J3301x6, as the patient is receiving 40 mg of the drug for every mL your provider administers (40 mg x 1.5 mL = 60 mg, or 6 units of 10 mg).