Ophthalmology and Optometry Coding Alert

Question: I code for a group of ophthalmologists in a university hospital. When an ophthalmologist does an intravitreal injection of Kenalog, I code 67028 for his service. In this setting, should I code separately for the Kenalog supply itself? If so, is it by units or cc's?

California Subscriber

Answer: Let the facility handle the supply coding. For procedures the ophthalmologist provides in a hospital, report only the physician services, in this case 67028 (Intravitreal injection of a pharmacologic agent [separate procedure]). The facility would report J3300 (Injection, triamcinolone acetonide, preservative free, 1 mg) or J3301 (...not otherwise specified, 10 mg) for the supply of the drug.

The ophthalmologist can report J3300 or J3301 if he injects it in the office. Code one unit of J3301 for each 10 mg the ophthalmologist injects.

Example: The ophthalmologist injects 20 mg of Kenalog. Report J3301 with "2" in the "units" column of the claim form.