Urology Coding Alert

Question: How should we bill for Trimix when used for erectile dysfunction?

Texas Subscriber

Answer: You should use the unlisted drug code J3490  (Unclassified drugs).

Enter one unit in box 24G on the CMS-1500 claim form or the equivalent box for electronic submission. In box 19 or the equivalent box for electronic transmissions report the name of the drugs, their dosages used, route of administration, their NDC numbers, and the total invoice price.

Good practice: Retain your invoices for possible submission to the payer upon request.