Oncology & Hematology Coding Alert

Question: How do we report the supply when the patient receives a human fibrinogen injection in a dose of 3670 mg? What is the change in HCPCS codes for human fibrinogen injection in 2013?

New Mexico Subscriber

Answer: Two human fibrinogen concentrate codes have been deleted in HCPCS 2013: J1680 (Injection, human fibrinogen concentrate, 100 mg) and Q2045 (Injection, human fibrinogen concentrate, 1 mg). Effective January 1, 2013 you have a new code J7178 (Injection, human fibrinogen concentrate, 1 mg).

Rationale for the change: The addition of J7178 places this code with the other clotting factor codes and helps to “standardize the ‘unit’ definition among the various clotting factors at 1 mg,” according to the May 8, 2012, HCPCS Public Meeting Summary Report (available from the Downloads section of www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/HCPCSPublicMeetings.html).

Calculating the units: Be aware that there is a large unit difference between J1680 (100 mg per unit) and J7178 (1 mg per unit). Using the new code J7178, you will report 3670 units for the dose of 3670 mg of fibrinogen injection that the patient is receiving. You need to alert coding staff of this change and reiterate the difference in units when reporting J7178 when compared to J1680. Thus, in 2012 you would have reported 37 units (rounding up for an increment less than a whole unit) if the dose of J1680 was 3,670 mg.