Cardiology Coding Alert

Question: How should I report Adenosine administration when the patient receives a 40-mg injection?


Montana Subscriber

Answer: You should report three units of J0152 (Injection, adenosine for diagnostic use, 30 mg [not to be used to report any adenosine phosphate compounds; instead use A9270]).

A "single-dose" vial designation of Adenosine contains 90 mg. When a patient receives only 40 mg of that 90 mg, the cardiologist discards 50 mg because this is what remains in a single-dose vial. For this patient, you should report the cost of the entire 90-mg vial. That means you'll bill J0152 x 3 units (30 mg x 3 = 90 mg), which accounts for the number of mg your cardiologist used and the number of mg discarded with a single-dose vial.
 
You should include a notation on the claim form that says, "40 mg used, 50 mg discarded" as well as "acquisition cost 90 mg Adenosine $XXX.XX." Remember, distributors recommend that cardiologists do not use one vial on two different patients, since a 90-mg vial equals a single dose.