I billed a J3301 with a J30.2 and it came back denied as Experimental or Investigational. The insurance is Coventry Aetna. Anyone having problems? Thanks.
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Tag Archives: J3301
J3301 confusion
I have a description of an ILK injection that says, "2 mL of ILK 20mg/mL (40 mg in total). The ILK in our office is either 10 mg/mL or 40 mg/mL. The physician says bill J3301 x 4. So, if the medicine was from the 40 mg vial wouldn’t that just be 1 unit? or 2 units if using 10 mg/mL vial? This is so confusing for me. I appreciate any help and also if anyone has a reliable formula for doing the math to figure this out I would appreciate knowing that too. Thanks.
J3301 billing
When administering less than 10mg, can we still bill J3301 with a quantity of 1? The code description states "10mg" and not "up to 10mg" as is the case for other drugs.
I understand on the facility side when the dosage is less than the amount indicated for the HCPCS code that it is acceptable to round up to 1 as the unit of measure. But does anyone have an authoritative source stating that also applies on the outpatient side?
Thanks in advance!
J3301 billing
When administering less than 10mg, can we still bill J3301 with a quantity of 1? The code description states "10mg" and not "up to 10mg" as is the case for other drugs.
I understand on the facility side when the dosage is less than the amount indicated for the HCPCS code that it is acceptable to round up to 1 as the unit of measure. But does anyone have an authoritative source stating that also applies on the outpatient side?
Thanks in advance!
J3301 billing
when a pt is in the office and recieves a Kenalog injection and is given 40 mg we use the J3301 hcpc code and then we normally change the quantity to 4. But when looking at the hcpc book with the code it says use this code for kenalog 40 does this mean that we should be leaving the quantity as 1 instead of changing it to 4 or should we be changing the quantity to 4 if 40 mg is given?
thanks!!