Forum - Questions & Answers

Jan 14th, 2019 - bets14687    1 

leuprolide acetate Lupron/Eligard J1950 versus J9217

I see that these two codes are perhaps gender specific. J1950 for treatment related to the uterus while J9217 for prostate cancer at least in the 3.75mg and 7.5mg dosages. Has anyone had payor problems interchanging these codes. Would you say either code okay to use for dosages different than 3.75mg and 7.5mg. What would you charge for administrations of 22.5mg and 30mg?

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Jan 17th, 2019 - ChrisW   130  1 

re: leuprolide acetate Lupron/Eligard J1950 versus J9217

leuprolide acetate is a gonadotropin-releasing hormone and is used for both males and females.

In females, it acts with a follicle stimulating hormone to promote ovulation as well as secretion of androgens and progesterone and with males, it stimulates the development and functional activity of testicular Leydig cells.

J9217 - Leuprolide acetate (for depot suspension), 7.5 mg
J1950 - Injection, leuprolide acetate (for depot suspension), per 3.75 mg

For administration report CPT code 96402, Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic, for the injection for Leuprolide acetate (for depot suspension).

You must also report any discarded or unused drug, therefore, if you report and bill for J9217 - Leuprolide acetate (for depot suspension), 7.5 mg and only use 5mg you must report the discarded amount using the JW Modifier on a separate line.

JW - DRUG AMOUNT DISCARDED/NOT ADMINISTERED TO ANY PATIENT

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