Forum - Questions & Answers

Sep 27th, 2011 - amycpmg

J1030 versus j1040 (depomedrol injection CPT)

Hello. Question of the day in our office. Patient receives an injection of 40 mg depomedrol for rash. The vial of med is a 5ml 80 mg MDV. Do we bill using the J1030 (40mg) or J1040 (80mg) and cut price in half? We currently use J1030 however our state medicaid denies because of the ndc code we use is showing the 80 mg dose vial we draw from and not the 40 mg dose vial ndc. Hope this makes sense.

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Sep 28th, 2011 - jschmutz   323 

re: J1030 VERSUS J1040 (DEPOMEDROL INJECTION CPT)

Your vial is 80mg/5mL? That doesn't make sense. Did you mean to state that your physician is injecting 5mL of 80mg/mL or .5ml of 80mg/mL?

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Oct 3rd, 2011 - DebraS   67 

re: J1030 VERSUS J1040 (DEPOMEDROL INJECTION CPT)

If you physician uses and dictates 40 then J1030, if he uses and dictates 80 then you'd bill the J1040. If he does 40 bilaterally then you'd bill the J1040 x 1. His dictation must support what is being billed as well as the ndc number matching as well.
The part of billing out J1030 with J1040's NDC does not make sense, it doesn't match up. That's probably why they are denying.

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