Neurology & Pain Management Coding Alert

Question: I can’t find a J code in the HCPCS book for a 500 mg vial of Valproate Sodium. Should we use the miscellaneous code J9999 (Not otherwise classified, antineoplastic drugs)? 

Ohio Subscriber

Answer: The better code actually is J3490 (Unclassified drugs). Your claim will include an explanation of the product and how much your provider used. 

Tip: It’s often helpful to include the corresponding NDC # when billing J3490. Patients often take the drug orally, which would typically be considered “self-administered” and therefore not covered by insurance. If your practice administered the drug intravenously, it’s a good idea to indicate this with a note such as “IV administration” in item 19 or the electronic equivalent.