Internal Medicine Coding Alert

Published on Mon May 11, 2009 PDF

Question: Our doctors frequently give 60 mg Depo-Medrol. HCPCS level-II offers codes for three sizes: 20 mg, 40 mg, and 80 mg. We stock 40 mg and 80 mg vials. Since theres no code for a 60 mg vial, we've been billing 3 units of J1020. Is that method correct?

Washington Subscriber

Answer: No, the strength does not equal the units.The 20, 40, and 80 mg vials represent or different strengths: Depo-Medrol20; Depo-Medrol40, and Depo-Medrol80. Each corresponds to a specific HCPCS code. For the 20 mg dosage, you would use J1020 (Injection; methylprednisolone acetate, 20 mg). If the internist gives 40 mg, you would report J1030 (Injection; methylprednisolone acetate, 40 mg). An 80 mg dosage of Depo-Medrol falls under J1040 (Injection; methylprednisolone acetate, 80 mg).

Each injection is one unit. If your physician is giving three separate injections of 20 mg (for a total of 60 mg),then you would bill three units of J1020. If he gives one injection of a 20 mg and a 40 mg, you would report one unit of J1020 and one unit of J1030

Some payers may have different requirements. Therefore, double-check with your major payers.