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Marilyn Posted Tue 05th of April, 2016 17:20:41 PM

What is the correct code used to bill for Prolia 60mg? J0897 or J3490?

SuperCoder Answered Wed 06th of April, 2016 08:58:57 AM

Earlier Prolia injection was billed using HCPCS code either J3490 (Unclassified drugs) or J3590 (Unclassified biologics) but effective from January 1, 2012, a new HCPCS procedure code J0897 has been assigned to the Prolia 60mg .

Marilyn Posted Wed 06th of April, 2016 10:58:03 AM


SuperCoder Answered Thu 07th of April, 2016 08:41:31 AM
To bill Prolia correctly you post the J0897 and bill 60 units or mg. As the billing unit is 1mg you have to charge for 60 mg or units to receive proper reimbursement. Thanks!

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