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All J-codes should be submitted with the number of units in Field 24-G on the HCFA-1500 form. Do not enter the dosage (i.e., the number of mg or grams) in Field 24-G.
Code one unit of service for the dosage that is indicated in the description of the J-code. Below is an illustration of how the units for J0696 (Rocephin) and J1100 (Decadron) should be coded.
Example #1: J0696 - Injection, ceftriaxone sodium, (Rocephin), per 250 mg (code one unit of service for each 250 mg of Rocephin)
Example #2: J1100 - Injection, dexamethasome sodium phosphate (Decadron), 1 mg (code one unit of service for each 1 mg of Decadron)
When submitting an unlisted or non-specific J-code (e.g., J3490, J8499, J9999), always enter one unit in Field 24-G and indicate the dosage of the drug on the HCFA-1500 form in Field 24-D under the J-code. The National Drug Code (NDC) is always helpful on unlisted J-code, if one is available. If the drug is a "compound drug", please indicate "compound drug" in Field 24-D.
POLICY GUIDELINESThe coding guidelines outlined in Coding Policy should not be used in lieu of the Member's specific benefits plan language.
POLICY HISTORY7/2004: Policy developed