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Depo Provera

I have numerous depo provera claims being denied by BCBS for invalid NDC#. I am attaching the NDC# directly off the medication which is 59762-4538-2 or 59762-4537-1. BCBS is the only carrier that is denying the depo claims for this reason. Is anyone else experiencing this? Does someone else have a different NDC# for depo provera?

Thank you for your help.

Medical Billing and Coding Forum

20610 (multiple units and location) and Depo medrol and labs (89051/89060)

Hi all,

I’ve asked the questions in a few different places on here and thought it would be better if all together to show the true picture. I’ve read all of the AAPC articles on the subject of 20610, so I’m familiar with when in diff joint etc, but there’s some confusion on joint and bursa in same general area. I’ve also read multiple threads on here and no absolute answer that I can locate.

Have a Dr billing insurance 20610 x 8 and J1040 x 8, as well as 89051 x4 and 89060 x4.

Here’s a breakdown of one of the scenarios:
Injection/Asp into RT shoulder w/ 45mg of NDC 00009028003
Injection/Asp into LT shoulder w/ 45mg of NDC 00009028003
Injection/Asp into RT subacromial bursa w/ 45mg of NDC 00009028003
Injection/Asp into LT subacromial bursa w/ 45mg of NDC 00009028003
Injection/Asp into RT hip w/ 45mg of NDC 00009028003
Injection/Asp into LT hip w/ 45mg of NDC 00009028003
Injection/Asp into RT trochanteric bursa w/ 45mg of NDC 00009028003
Injection/Asp into LT trochanteric bursa w/ 45mg of NDC 00009028003
Performs synovial fluid analysis for all areas mentioned with wbc provided and no crystals shown.

Questions:
1) Since bursae and shoulder/hip joints are technically different, does the above look correct? Or are they close enough to the joint that you only get the code (20610) once per joint space? CPT wording makes it look like you can get joint AND bursa, so I want to make sure that’s correct.
2) The NDC provided is for J1030, so should it actually be J1030 x9 instead of J1040 x 8?
3) Does 89051 x 4 and 89060 x 4 seem appropriate/accurate if notating wbc’s count and no crystals? (E.G. "LT hip: 5000 wbc and no crystals") Is this notation suffice?

Thank you all SO MUCH for any insight.

Medical Billing and Coding Forum

Depo or other contraception with office visit

Good afternoon,

I know I have read many threads on depo’s, and implants. My question is, can a patient come in already decided to have the certain contraceptive and is scheduled to have that contraceptive, the documentation states only that the patient came in for the contraceptive and it is billed out as an office visit (25 modifier) and the contraceptive? IF they cannot, under what circumstances can they? If the clinicians ask the patient how they are doing on the depo, are they having any bleeding, ect… does this warrant a separate visit and why not? Is this included in the reimbursement for the giving of the contraceptive? If so, is there any guidelines on this that I can easily go to and print off.

Sometimes, a link is left and it is broken up with a "…" and I cannot go the page or you have to be a paid member of that organization, such as ACOG. I really need some good feed back to take to back so I can explain this fully why or why not.

Thank you EVERYONE for your help.

Medical Billing and Coding Forum

Billing Depo injections

Good afternoon All,

Can anyone tell me the correct ICD 10 code to bill for subsequent depo injection? For the initial injection we bill Z30.013. I am thinking we would bill Z30.42, which is Encounter for surveillance of injectable contraceptive. I just don’t see any codes that state subsequent injection.

Thoughts?

TIA

Denise

Medical Billing and Coding Forum