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.
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.