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Ob-Gyn Coding Alert

Reader Questions:

How to Report Hydroxyprogesterone Caproate

Published on Tue Jun 28, 2005

Question: We have started giving hydroxyprogesterone caproate in our office to prevent pre-term labor. The problem is I don't know where to start looking for a HCPCS code, and I've found two different NDC numbers for it. Please help.


California Subscriber
 

Answer: Your only option is to bill either J3490 (Unclassified drugs) or 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other service rendered [list drugs, trays, supplies, or materials provided]) and submit the National Drug Code (NDC) number for the drug.
 
The NDC number represents the manufacturer, package size and dosage. Look for it on the package from which you're dispensing the drug.

In the past, you could have used two codes for this drug, J1739 (Injection, hydroxyprogesterone caproate, 125 mg/ml) and J1741 (Injection, hydroxyprogesterone caproate, 250 mg/ml), but Medicare deleted both from the HCPCS database in 2002.
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