Oncology & Hematology Coding Alert

Question: Please discuss the difference among 0.9 percent sodium chloride in 20ml vials, 250ml bags and 500ml bags. Are there specific J-codes for each?

Linda Edwards,
Hope Community Cancer Center, Marmora, N.J.

Answer: There is only one code to describe sodium chloride, 0.9 percent. The supply that you have (250ml bags) is not important when coding. Code J2912 (injection, sodium chloride, 0.9%, per 2 ml) should be used for each 2 ml given by IV to the patient.

For more than 2 ml used per patient, you would bill for the amount of sodium chloride used. For instance, if you administer 4 ml of sodium chloride to a patient, enter J2912 with 2 in the days unit column of the HCFA 1500 form.

Any volume of IV fluids under 250 ml is considered part of the chemotherapy administration fee and is not a separately allowed service. Charges for this code should be included in the fee(s) for chemotherapy administration. Chemotherapy administration guidelines were published in the May 1996 Medicare Advisory.

Editors note: This question was answered by Laurie A. Castillo, MA, CPC, president of Physician Coding & Compliance Consulting and the American Association of Procedural Coders Northern Virginia Chapter, both in Manassas, Va.