J2919 Code – Injection, methylprednisolone sodium succinate, 5 mg
J2919 Code Description?
The Healthcare Common Procedure Coding System (HCPCS) J2919 Code for Injection, methylprednisolone sodium succinate, 5 mg has been newly added by CMS for drugs administered by injection, effective as of April 1, 2024.
It is crucial to utilize HCPCS J2919 Code for billing purposes when administering methylprednisolone sodium succinate, and to discontinue the use of HCPCS codes J2920 and J2930 as they are no longer valid after the effective date. When billing for this injection, it is essential to adjust the number of units billed to prevent under-billing. For HCPCS J2919, 8 units should be billed for every 1 unit typically used for HCPCS J2920(40mg) to accurately reflect the dosage administered. For instance, if you are using a 40 mg vial for a patient, and each unit is 5 mg, billing 8 units would be appropriate to avoid drug waste and ensure correct billing practices.
Coverage for methylprednisolone (J2919) is limited to situations where the medication cannot be taken orally and is self-administered by the beneficiary. Claims not meeting this criterion will be denied as not medically necessary.
This revision and guidance aim to streamline the billing process for methylprednisolone sodium succinate injections and ensure accuracy in reporting dosages administered to patients.
Key Guidelines for HCPCS J2919 Code: Injection of Methylprednisolone Sodium Succinate, 5 mg
1. Usage of HCPCS J2919 Code: Ensure the exclusive use of HCPCS J2919 Code for administering Methylprednisolone Sodium Succinate, 5 mg, and discontinue the use of outdated codes J2920 and J2930.
2. Unit Adjustment: Adjust units billed to prevent under-billing. For HCPCS J2919, bill 8 units for every 1 unit usually billed for HCPCS J2920 (40mg), aligning with the dosage administered.
3. Coverage Criteria: Coverage for Methylprednisolone (J2919) is limited to scenarios where the medication cannot be self-administered by the beneficiary. Claims failing to meet this criterion will be denied as not medically necessary.
4. Compliance and Billing Accuracy: Adhere to these guidelines to streamline the billing process for Methylprednisolone Sodium Succinate injections, ensuring compliance with CMS regulations and accurate dosage reporting.
By integrating these key guidelines into practice, healthcare providers can enhance efficiency, accuracy, and compliance in administering Methylprednisolone Sodium Succinate, benefiting both providers and patients.
How to bill units for J2919 Code?
When billing units for HCPCS J2919 Code, it is important to accurately reflect the dosage administered to the patient. Each unit of J2919 represents 5 mg of Methylprednisolone Sodium Succinate. Here are two scenarios to illustrate how to bill units for J2919:
Scenario 1:
If a patient requires a 20 mg dose of Methylprednisolone Sodium Succinate, you would bill 4 units of HCPCS J2919 Code to properly account for the dosage administered. This is calculated by dividing the total dosage (20 mg) by the unit dosage (5 mg per unit), resulting in billing 4 units of J2919.
Scenario 2:
In a scenario where a patient requires an injection of methylprednisolone sodium succinate, and each vial contains 100 mg of the medication, you would need to adjust the billing accordingly. Since each unit billed represents 5 mg, billing 20 units of J2919 is appropriate in this context to accurately reflect the dosage administered to the patient.
By following these examples and understanding the unit dosage associated with J2919, healthcare providers can ensure that they bill appropriately for the dosage of Methylprednisolone Sodium Succinate administered to patients, thereby facilitating accurate billing practices.
NDC Code J2919
| NDC | New HCPCS | Old HCPCS | NDC Label | Number of items in NDC Package | NDC Package Measure |
|---|---|---|---|---|---|
| 00009-0698-01 | J2919 | J2930 | SOLU-MEDROL (MDV) 1 GM | 1 | EA |
| 00009-0698-02 | J2919 | J2930 | PREMIERPRO RX SOLU-MEDROL 1GM VIAL (LYOPHILIZED) 1 GM | 1 | EA |
| 00009-0758-01 | J2919 | J2930 | SOLU-MEDROL (MDV) 500 MG | 1 | EA |
| 00009-0850-01 | J2919 | J2930 | SOLU-MEDROL (LYOPHILIZED) 2 GM | 1 | EA |
| 00143-9753-25 | J2919 | J2920 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV,LATEX-FREE) 40 MG | 25 | EA |
| 00143-9754-25 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV,LATEX-FREE) 125 MG | 25 | EA |
| 00143-9850-01 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 500 MG | 1 | EA |
| 00143-9851-01 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 1 GM | 1 | EA |
| 25021-0807-05 | J2919 | J2920 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 40 MG | 10 | EA |
| 25021-0808-10 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 125 MG | 10 | EA |
| 25021-0810-30 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LATEX-FREE,LYOPHILIZED) 1 GM | 1 | EA |
| 43598-0127-25 | J2919 | J2920 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV) 40 MG | 25 | EA |
| 43598-0128-11 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 500 MG | 1 | EA |
| 43598-0129-25 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV) 125 MG | 25 | EA |
| 43598-0130-74 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (LYOPHILIZED) 1 GM | 1 | EA |
| 63323-0255-03 | J2919 | J2920 | METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG | 25 | EA |
| 63323-0258-03 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG | 25 | EA |
| 63323-0265-30 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (PF) 1 GM | 1 | EA |
| 70121-1000-05 | J2919 | J2920 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV,LYOPHILIZED) 40 MG | 25 | EA |
| 70121-1001-05 | J2919 | J2930 | METHYLPREDNISOLONE SODIUM SUCCINATE (SDV,LYOPHILIZED) 125 MG | 25 | EA |