Primary Care Coding Alert

If a patient reports to the FP for an injectable migraine treatment, the supply code choices can send a coder's head spinning. We asked Marvel Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, owner of Denver's MJH Consulting, if there was a list of injectable drugs that migraine patients receive.

There is no complete list of injectable migraine medications anywhere, but "these are the more common injectable medications potentially administered in a physician office," Hammer offered:

• Toradol: J1885 (Injection, ketorolac tromethamine, per 15 mg)
• Triptans, (or Imitrex, Sumatriptan): J3030 (Injection, sumatriptan succinate, 6 mg [code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered])
• DHE-45 (or Migranal): J1110 (Injection, dihydroergotamine mesylate, per 1 mg)
• Butorphanol, (or Stadol): J0595 (Injection, butorphanol tartrate, 1 mg)
• Demerol: J2175 (Injection, meperidine HCL, per 100 mg)
• Botulinum toxins: J0585 (Injection, onabotulinumtoxinA, 1 unit) through J0587 (Injection, rimabotulinu toxinB,100 units).

Additionally: The FP might also inject the following drugs "for nausea associated with migraines," says Hammer:

• Compazine: J0780 (Injection, prochlorperazine, up to 10 mg)
• Phenergan J2550 (Injection, promethazine HCL, up to 50 mg).

Caveat: You likely won't come into contact with all of these supply codes. The amount and variety of migraine drugs in the primary care setting will "depend upon the quantity of active migraine patients" your FP treats, Hammer reminds.