Ob-Gyn Coding Alert

You could start submitting 250 units of this code per weekly dose.

If your ob-gyn administers Hydroxyprogesterone caproate Injections (trade name Makena™), then you should be aware of the new HCPCS code Q2042 (Injection, Hydroxyprogeserone caproate, 1 mg). Note: this Q code does not specify Makena™ as the product that must be dispensed when using this code. You should report the compounded injections this same way. Notice also that the dosage is 1 mg. The usual dosage is 250 mg (1 mL) once weekly. Until such time as CMS states they have incorrectly specified the dosage amount (perhaps having meant 1 mL rather than 1 mg), your quantity will be 250.

This is a synthetic progestin and is the first and only FDA approved progestin indicated for the prevention of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth. The ob-gyn may administer Makena intramuscularly once weekly, starting between 16 weeks, 0 days and 20 weeks, 6 weeks gestation. The treatment ends at 37 weeks gestation or delivery, whatever occurs first.

Remember: Preterm birth means the patient delivers before her pregnancy has reached 37 weeks gestation.

The FDA will allow pharmacies to continue compounding the drug, so the manufacturer is saying they will lower the price per injection. To read about the issues surrounding this drug, go to URL: www.aafp.org/online/en/home/publications/news/news-now/health-of-the-public/20110404makenacost.html.