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J2997 code should have an administration code attached

Posted By Total Vascular Care, Monday, May 04, 2015

 

We recently began using a new billing company and they informed me that when billing the J2997 CPT code (activase) during thrombectomy, we should also bill an administration code. We've never done this before. Is anyone else familiar with billing an administration code with J2997 (TPA)?

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Timothy A. Pflederer says...
Posted Wednesday, May 06, 2015
J2997 should not be used during a thrombectomy because the code 36870 includes practice expense payment for all devices and anticoagulant-thrombolytic drugs used. You certainly cannot also code an "administration fee" as this is also inherent in 36870
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Total Vascular Care says...
Posted Wednesday, May 06, 2015

Thank you for your response. You may want to look into coding of J2997. If you can reference the ASDIN coding app it explains when you can code for J2997. If not, this is taken directly from ASDIN Coding app in regards to 36870. "This code includes all the work required to remove the thrombus from the access, declot the graft and restore flow to the access regardless of the method used. It includes both mechanical and pharmacological techniques. It does not, however, include any pharmacological agents that might be used. If tPA (alteplase) is used then the code J2997 should be applied. This code is for 1 mg of the drug. If more than this is used, then the code may be used more than once". I hope you find this reference useful for your practice. Thanks
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Timothy A. Pflederer says...
Posted Thursday, May 07, 2015
Thanks for your correction of my error. I did realize that our manual states J2997 can be coded separately but believed this to possibly be in error because thrombolytics are included in practice expense for 36870. I went back to the RUC database and found that I was incorrect. Heparin is included in the practice expense but TPA is not. So you are correct that J2997 can be billed separately in a thrombectomy case in site of service 11. I appreciate you correcting this. It would not be appropriate to code an “administration fee” because the work of administration is included in 36870 for both physician and staff.
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Total Vascular Care says...
Posted Thursday, May 07, 2015
Thank you Mr. Pflederer for responding to the initial comment and I appreciate your feedback. I'm glad this blog was able to help the both of us. Good luck!
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