READER QUESTION ~ Avoid Half-Units of Adenosine
Published on Thu Feb 22, 2007
Question: If we use the entire vial of a 20-mg vial of adenosine during a nuclear study, how should we bill that -- J0150 (Injection, adenosine for therapeutic use, 6 mg) x 3.5 units? I don't think we can report J0152 for 30 mgs if the patient was given only 20 mgs.
Oregon Subscriber Answer: You should code adenosine used for a nuclear study with J0152 (Injection, adenosine for diagnostic use, 30 mg). Notice how this code descriptor shows 30-mg vials. That is usually how your supply comes, and therefore that is the increment HCPCS assigns.
If you use one vial, you should bill for one unit. Your cardiologist administers adenosine based on the patient's weight. So if the patient is less than 200 lbs., you will usually use 2 units. If your doctor uses 2.5 units, you should bill for 3 because you cannot bill for 0.5 units. You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.
