Oncology & Hematology Coding Alert
Claim 6 Units of J2505? A Denial's on Its Way
Published on Tue Jul 11, 2006
Avoid this common pegfilgrastim reporting pitfall Be prepared for any six-unit J2505 claim to boomerang back to your practice.
Why? Too many providers are claiming J2505 (Injection, pegfilgrastim, 6 mg) per milligram instead of per unit (1 unit = 6 mg), according to MLN Matters article MM4380, -Billing Clarification for J2505 Pegfilgrastim- (www.cms.hhs.gov/MLNMattersArticles/downloads/MM4380.pdf).
Because the pegfilgrastim typically comes in 6- mg pre-filled syringes, many providers claim 6 units (instead of the accurate 1 unit per 6 mg). Result: Contractors will return any claim for 6 units of J2505, effective Aug. 14.
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