kookykk
Contributor
As a Pediatric office, we give oral dexamethasone for Croup. We have been billing J8540 for this since it was given orally and not injected, but recently a major payer is denying this code and leaving the charges to patient balance. One patient has stated the payer told her J8540 is an RX so it is not covered under their Medical Benefits. I cannot find definitive documentation to tell me if you can bill the J1100 when giving the Dexamethasone orally, rather than injecting. Does anyone know or have good documentation to support billing either way so we can make sure we are billing appropriately? Thank you.