Primary Care Coding Alert

Reader Questions:

Extra Documentation May Be Necessary for Unlisted J Code Payment

Question: The FP performs an IV infusion of diltiazem HCl, also known as Cardizem or Tiazac. Which J code should I report for the drug supply?

New Hampshire Subscriber


Answer: You should report J3490 (Unclassified drugs), unless your payer instructs otherwise, because no permanent HCPCS code has been assigned to diltiazem HCl.

Depending on which insurer is processing your claim, you may also need to submit documentation with your claim to show which drug you administered, how much you administered, and for what condition you used it.

 -- Answers to You Be the Coder and Reader Questions reviewed by Kent J. Moore, manager of Health Care Financing and Delivery Systems for the American Academy of Family Physicians in Leawood, Kan.

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