Pediatric Coding Alert

Reader Questions:

J0559 Replaces J0530-J0550, Not Bicillin L-A Codes

Question: I thought I understood how to use J0530-J0550 but insurers are denying the codes. What is the proper coding for Bicillin L-A and Bicillin C-R using units?
Codify Member

Answer: HCPCS 2010 deleted J0530-J0550. You should instead use J0559-J0580.

To bill for the combination product, penicillin G benzathine and penicillin G procaine (Bicillin C-R), use J0559 (Injection, penicillin G benzathine and penicillin G procaine, 2500 units).

This is the replacement code for J0530-J0550. Bill one unit of J0559 for every 2,500 units of Bicillin C-R administered. So if you are administering 1.2 million units, report J0559 x 480 units (1,200,000/2500). Other common amounts administered and corresponding units include:

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