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J 1825 , J1826, Q3025

Janet Posted Mon 01st of August, 2011 19:09:34 PM

I know that J1825 was changed to Q3025 at the beginning of 2011. THis is for AVONEX self injectable administered at home.
On the claim form, in box 24G I have 30 days and circle the days instead of the units.

called the drug company and was told that j1825 was switched to j1826 whereas at the beginning of the year I was told it was switched to Q3025..And was also told all 3 codes are for 30mcg.
how do i complete the claim form...could you please inform me in detail.
Can you please inform me ASAP.
Thanks
Janet

SuperCoder Answered Mon 01st of August, 2011 20:44:31 PM

Please simplify your question.
The following are the HCPCs started to be used in place of J1825:-
Q3025 Injection, interferon beta-1a, 11 mcg for intramuscular use
Q3026 Injection, interferon beta-1a, 11 mcg for subcutaneous use
***
Need to know the details of documentation which will be helpful for submitting the codes.

Janet Posted Mon 01st of August, 2011 23:35:34 PM

J1826...injection, interferon beta-1a..30mcg.
my question is as follows: in box 24d of the hcfa claim form....what do I need to input...30 days(since it is for 30 day supply...4 injections for once a week) or the unit amount which is a question mark...( each injection is 30mcg or .5ml which means...4 injection/month= 2 ml)?
thanks

Janet Posted Mon 01st of August, 2011 23:37:43 PM

Even if billed under Q3025 ( which is 11mcg)....which each avonex injectables is 30mcg x 4 injects/month
...how would you bill it in the days/unit section 24G?

SuperCoder Answered Tue 02nd of August, 2011 14:11:33 PM

THis is for AVONEX self injectable administered at home.
--------------------------------------------------------
Usual Dosage:
Avonex: 30 mcg IM once per week.
Each vial of reconstituted solution contains 30 mcg/1.0 mL Interferon beta-1a.
HCPCs code to be used: J1826
The supply is for 30 days, 4 units to be purchased at a time, and scheduled to be taken once puchased
So, number of Units to be billed= 4 units.

Answer: Insert the value "4" in the box 24G.

FOR CONCEPT, REFER THE DETAILS BELOW:
=========================================================================================
Box Number 24F
Instructions: Enter the dollar amount for each service in the unshaded area. Do not use dollar signs. Do not use commas as thousands marker. Use a space to separate parts of field. If more than one date or unit is shown in 24G, the dollars shown should reflect the TOTAL of the services. If grouping services, the charges for each item
within a group must be identical (24F must be evenly divisible by 24G).
***
Box Number 24G
Title: DAYS OR UNITS [lines 1 – 6]
Instructions: Enter the number of days or units on each service line in the unshaded area. Multiple units may indicate either services on consecutive days (grouping) or more than one unit billed for a single date of service. Grouping services entered must correspond with the number of days in box 24A. Grouping is allowed only for services on consecutive days. For the shaded area, refer to Section 24 Shaded Area guidelines below:-
***

Section 24 Shaded Area
Title: This section is untitled.
Instructions: Enter the supplemental information in the shaded section of 24A through 24G above the corresponding service line.
Definitions: The six service lines in section 24 have been divided horizontally to accommodate submission of both the NPI and another/proprietary identifier during the NPI transition and to accommodate the submission of supplemental information to support the billed service. The top area of the six service lines are shaded and is the location for reporting supplemental information. It is not intended to allow the billing of 12 lines of service. Supplemental information can only be entered with a corresponding, completed service line.
…..
Format: The shaded area of lines 1 through 6 allows for the entry of 61 characters from the beginning of 24A to the end of 24G. …… Used for: Provide supplemental information.
***
=========================================================================================

Janet Posted Tue 02nd of August, 2011 14:22:19 PM

I would like to find out if units or days should be filled in box 24G.....is it a must to fill in units or days.

Janet Posted Tue 02nd of August, 2011 14:36:20 PM

And if unit is what is required, am i supposed to input in box 24F 1/4 (4 units...4 syringes) of what the total charge is in box 28.
or if days is what is required, am i supposed to input in box 24F 1/30 (30 dy supply) of what the total charge is in box 28.

Janet Posted Tue 02nd of August, 2011 15:43:18 PM

Can you please also tell me ...date of service box...do I write e.g.from 1/1/2011 to 1/1/2011 for 30 days supply or
from 1/1/2011 to 1/30/2011 for 30 day supply....which is correct

SuperCoder Answered Tue 02nd of August, 2011 15:55:04 PM

With this reply of yours, I focused my attention to your first statement, "On the claim form, in box 24G I have 30 days and circle the days instead of the units". It seems something different type of claim form. Can you send such a sample billing form in attachment on my email id: smishra@codinginstitute.com ... so that I can clear your confusion.
***
I already had my answer ready, but I think I need to clear your confusion after going through your mail.

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