CPCA HCPCS Coding for Injectables 3 — Questions and Answers
Question 1: A patient receives 50 mg of diphenhydramine HCl injection. The HCPCS code J1200 covers up to 50 mg. How many units are billed?
- 0.5 units
- 1 unit (Correct answer)
- 2 units
- As documented by the physician
Correct answer: 1 unit
Since exactly 50 mg was administered and J1200 covers up to 50 mg, 1 unit is reported.
Question 2: Which HCPCS code is assigned for ondansetron HCl injection, up to 1 mg?
- J2405 (Correct answer)
- J2175
- J2270
- J2430
Correct answer: J2405
J2405 is the HCPCS code for ondansetron HCl injection, up to 1 mg.
Question 3: When a compounded injectable drug has no specific HCPCS code, which code is most appropriate?
- J3490
- J3590 (Correct answer)
- J9999
- C9399
Correct answer: J3590
J3590 (Unclassified biologics) is used for compounded injectables without a specific HCPCS code; J3490 covers unclassified drugs.
Question 4: A physician administers 10 mg of ketorolac tromethamine injection. The HCPCS code J1885 is per 15 mg. How should this be billed?
- Bill 0 units since dose is below threshold
- Bill 1 unit rounding up (Correct answer)
- Bill 10 mg with a special modifier
- Document only; no HCPCS code applies
Correct answer: Bill 1 unit rounding up
Partial units are rounded up to the next whole billable unit, so 10 mg of a 15 mg/unit drug bills as 1 unit.
Question 5: Which of the following injectable drugs is reported using HCPCS code J0696?
- Ceftriaxone sodium (Correct answer)
- Cefazolin sodium
- Cefepime HCl
- Ceftazidime
Correct answer: Ceftriaxone sodium
J0696 is the HCPCS code for ceftriaxone sodium injection, 250 mg.
Question 6: For chemotherapy injectable drugs without a specific HCPCS J-code, which code category is typically used?
- J3490
- J9999 (Correct answer)
- C9399
- Q0083
Correct answer: J9999
J9999 is the unclassified antineoplastic drug code used when a specific HCPCS code does not exist for a chemotherapy agent.
Question 7: Which HCPCS code is used for immune globulin (IgIM), human, injection, 500 mg?
- J1460 (Correct answer)
- J1557
- J1559
- J1561
Correct answer: J1460
J1460 is the HCPCS code for immune globulin (IgIM), human, per 500 mg.
CPCA HCPCS Coding for Injectables 3
A patient receives 50 mg of diphenhydramine HCl injection.
The HCPCS code J1200 covers up to 50 mg.
How many units are billed?