Wiki Coding - orthopaedics

[cjchenel]

Hi,

I am looking to see how to code HCPCS code J0702 betamethasone acetate 3mg/betamethasone phosphate 3mg (Celestone) correctly. Our providers sometimes will indicate usage in cc or mg and the order and coders need to figure out how many Units this is to bill correctly.

After some research this is what we found:

0.25 cc - 1.5 mg/6 mg = 1 unit
0.5 cc - 3mg/6mg = 1 unit
0.75 cc - 4.5mg/6mg = 1 unit
1.0 cc - 6mg/6mg = 2 units
2.0 cc - 12mg/12mg = 4 units

Would someone let me know if this is correct?

Also, does anyone know a website or the best way to look up HCPCS drug codes to code them in UNITS. I have googled units/volume measurements but can not seam to find 1 place to go to when we use different drugs to inject into different body parts.

Kindly,
Cathy.

 

[Pam Warren]

This is one of the most challenging parts of medication billing. So let's go back to science class......

milligrams (mg) is weight. That's how HCPCS defines J0702. 3mg is one unit.

cc (cubic centimeters) and ml (millileters) are volume (and are interchangable). Volume is not the same thing as weight. Think about two different measurements: cups and pounds. You can't easily mathematically convert the two. Think about it.....a cup of water weights less than a cup of liquid mercury.

So, you need to know how much weight in mg of the Celestone is within the volume cc or ml of the syringe.

Look on the box. (sometimes I'll ask the medical assistant to photocopy the box and scan it over to me...no kidding...) I find that the medical assistants struggle with the calculations, so it's better for me to figure it out myself. Anyway, the box should tell you the weight in mg of the drug within the volume of liquid (which contains inert liquid to deliver the medication intramuscularly/subcutaneously (or intravenously, depending). Usually it's mg/ml, with ml being the volume of the syringe. sometimes it's mg/cc, but it depends. Remember cc and ml are interchangable, they're two different names for the same volume.

Once you know the weight in mg of the drug in the volume, then you can determine the units.

For example, if 3mg of Celestone is within 6ml or 6 cc of volume, then 1 unit was given. If the provider states 18 cc was given, then you can assign 3 units--6*3 is 18. (but make sure the compound is 3mg/6ml first).

Hope this helps.