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Nicole Posted 5 Year(s) ago

The J1055 (Depo Provera, 150 mg) code has been deleted as of 2013 and the J1050 (Depo Provera, 1 mg) has replaced it.

Is J1050 supposed to be billed with 150 units when billing?

Any help would be great! I cannot seem to find much information about this anywhere.

SuperCoder Posted 5 Year(s) ago

Procedure code J1050 may be reimbursed for services rendered to female clients as medically appropriate for the purpose of contraception (as a replacement for procedure
code J1055) or to male and female clients of any age for other indications as appropriate (as a replacement for procedure code J1051).
Procedure code J1050 must be billed as follows:
• Modifier U1 must be billed if the services are contraception only (i.e., J1050 is replacing J1055).
• No modifier must be billed if the services are for reasons other than contraception (i.e., J1050 is replacing J1051).
Providers must bill the appropriate quantity based on the amount used in milligrams (mg).

Please check the link:

http://www.tmhp.com/News_Items/2012/12-Dec/TMB_05_HCPCS%20Special%20Bulletin%202013.pdf Page 7

Posted by Nicole, 5 Year(s). There are 2 posts. The latest reply is from SuperCoder.

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