Internal Medicine Coding Alert

Reader question:

Methylcobalamin Takes You to HCPCS Code J3490

Question: One of our physicians wants to order Methylcobalamin for a patient who cannot have the basic B-12 cyanocobalamin. He wants to verify whether the patient's insurance will cover Methylcobalamin before he places an order. What HCPCS code should we submit when checking?

Illinois Subscriber

Answer: You would normally submit J3420 (Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg) for cyanocobalamin, and HCPCS coding notes instructs you to bill J3420 for other types of similar medications. Searching for the correct code for Methylcobalamin B-6/B-12, however, leads you to J3490 (Unclassified drugs). Include a note in Box 19 explaining what the medication is and why your physician ordered it.

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