Wiki Payment for J1100

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skmcdaniel

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Our providers use dexamethason 10mg/1ml vials when giving injections. I have been billing this as J1100 with 10 units. Is this the right way to code this? I just got reimbursement from Medicare for a patient and they only paid $1.41 for the medication - that seems VERY low to me. Should the units be greater than 10 - or is there a different J code to use for the medication? Thank you for any feedback!!
 
skmcdaniel said:
Our providers use dexamethason 10mg/1ml vials when giving injections. I have been billing this as J1100 with 10 units. Is this the right way to code this? I just got reimbursement from Medicare for a patient and they only paid $1.41 for the medication - that seems VERY low to me. Should the units be greater than 10 - or is there a different J code to use for the medication? Thank you for any feedback!!
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Medicare reimbursement for all injectable meds is very low. You are using the correct code and correct amount of units if it's being administered IM and your providers are giving the full 10mg/ml. You might want to look into the cost of what your practice is paying for the dexamethasone. They may need to change the way you purchase it. We order 30ml multi-dose vials which is cheaper.
 
96372
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
 
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