Wiki Kenalog billing less than 10mg

[JesseL]

I'm still not 100% about this..

Say a provider drawn 2 mg from a kenalog 10 bottle and injected those 2 mg to the patient. Do I still bill J3301 AS 1 unit or not bill it at all since I cant bill 0.2 units?

 

[tabytha]

I would bill it as 1 unit

 

[CatchTheWind]

My understanding is that this code is for any amount up to 10 mg, so you are fine.

 

[Texascoder64]

Does anyone have a good material resource that shows how to properly document and bill for ILK (10mg) and IM (Kenalog 40)

I need something that I can give to our clinical staff so they understand the units on the J3301 and an injection note template example for each for be very helpful as well.

thank you

 

[jdemar]

J3301 2.5mg/ml 0.3cc

Does anyone have a referral source on this previous email chain. Do I bill 1 unit even though they injected less? Thank you in advance. J

 

[JesseL]

Does anyone have a good material resource that shows how to properly document and bill for ILK (10mg) and IM (Kenalog 40)

I need something that I can give to our clinical staff so they understand the units on the J3301 and an injection note template example for each for be very helpful as well.

thank you

They can document how much CC injected and you do the math.

If 1 CC of kenalog 10 injected you bill 1 unit since it's 10mg per a CC (look at the bottle)

If 1 CC of Kenalog 40 injected you bill 4 units since its 40mg per CC, as in 10mg per 0.25CC.

Still not too sure about anything less than 10mg though.. since the code itself doesn't say "up to" 10 mg

 

[mhstrauss]

The guidance about this is towards the bottom of page 5, I believe. Basically, you can't bill a "partial" dose on the claim. If anything less than the dose described by the HCPCS code is used, you round up to 1 unit.


https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c17.pdf

HTH!

 

[syllingk]

you can only bill wastage of a drug if it is packaged in a single dose vial and any extra is wasted(not used on another patient)