icd 10 code for zoledronic acid infusion

What is the ICD 10 code for zoledronic acid?

CPT CODE J3489, J9310, J9201 - Medical Billing and Coding - Procedure code, ICD CODE. Zoledronic acid is indicated for the treatment of:

What is the ICD 10 code for uric acid metabolism?

T50.4X5A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Adverse effect of drugs affecting uric acid metabolism, init. The 2018/2019 edition of ICD-10-CM T50.4X5A became effective on October 1, 2018.

What are the indications for zoledronic acid for the treatment of cancer?

Zoledronic acid is indicated for the treatment of: Bone metastases from solid tumors in conjunction with standard antineoplastic therapy, including bone metastases from multiple myeloma, breast carcinoma, prostate carcinoma, and other solid tumors. Note: Prostate cancer should have progressed after treatment with at least one hormonal therapy;

What is the ICD 10 code for antineoplastic immunotherapy?

Encounter for antineoplastic immunotherapy. Z51.12 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2020 edition of ICD-10-CM Z51.12 became effective on October 1, 2019. This is the American ICD-10-CM version of Z51.12 - other international versions of ICD-10 Z51.12 may differ.

What is the CPT code for zoledronic acid infusion?

Group 5CodeDescriptionJ3489Zoledronic acid 1mg

How do you bill for zoledronic acid infusion?

HCPCS code J3489 (Injection, zoledronic acid, 1 mg) should be used to report Zometa®). The number of units billed on a claim should be 4 since Zometa is given as a single 4 mg injection for the indications outlined in the LCD.

What is zoledronic acid infusion?

Zoledronic acid (ZOL) is an intravenous bisphosphonate that is given once yearly for the treatment of osteoporosis via a medically supervised 15-minute infusion. This ensures compliance for a full 12 months.

Does Medicare cover zoledronic acid infusion?

Injectable Drugs Coverage Medicare Part A or Medicare Part B will pay for a portion of the cost of osteoporosis medications delivered intravenously or by injection. These medications may include ibandronate (Boniva), zoledronic acid (Reclast), denosumab (Prolia) and sometimes calcitonin (Miacalcin).

What is the ICD 10 code for osteoporosis?

0 – Age-Related Osteoporosis without Current Pathological Fracture. ICD-Code M81. 0 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Age-Related Osteoporosis without Current Pathological Fracture.

How do you Reclast a bill?

The appropriate HCPCS Level II supply code for Reclast® is J3489 Injection, zoledronic acid, 1 mg. For an initial infusion of Reclast® lasting 16 minutes or longer, report 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour.

Is zoledronic acid the same as Reclast?

Reclast and Zometa are two different brands of zoledronic acid. Reclast is used to treat or prevent osteoporosis caused by menopause, or steroid use. This medicine also increases bone mass in men with osteoporosis. Reclast is for use when you have a high risk of bone fracture.

How often do you get zoledronic acid infusion?

For bone cancer and multiple myeloma, this medicine is usually given every 3 to 4 weeks. This treatment will continue until your body responds to the medicine. For osteoporosis, this medicine is usually given once a year and will continue until your body responds to the medicine.

How many zoledronic acid infusions can you have?

The usual dose is 5 mg given as one infusion per year into a vein by your doctor or nurse. The infusion will take at least 15 minutes. In case you recently broke your hip, it is recommended that Zoledronic acid 5 mg is administered two or more weeks after your hip repair surgery.

Is zoledronic acid covered by insurance?

As with all medications, the cost of zoledronic acid can vary. Factors that may affect the price you'll pay include your treatment plan and your insurance coverage. It may also depend on the cost of the visit to a healthcare professional to receive doses of zoledronic acid.

What is the CPT code for Reclast infusion?

The code 96365 is used to code for the 20-minute Reclast infusion. For the infusions to be considered as an initial hour, the infusion has to be at least 16 minutes long.

Is Reclast IV covered by Medicare?

Do Medicare prescription drug plans cover Reclast? No. In general, Medicare prescription drug plans (Part D) do not cover this drug.

What does CPT code 96365 mean?

CPT® Code 96365 in section: Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug)

Can you bill an office visit with an infusion?

Intravenous (IV) infusions are billed based upon the CPT®/HCPCS description of the service rendered. A provider may bill for the total time of the infusion using the appropriate add-on codes (i.e. the CPT®/HCPCS for each additional unit of time) if the times are documented.

Is Reclast infusion covered by Medicare?

Do Medicare prescription drug plans cover Reclast? No. In general, Medicare prescription drug plans (Part D) do not cover this drug.

How much does Reclast cost?

The average retail price for Reclast is $1,318.15 for 1, 100ML of 5MG/100ML Solution of Reclast. Ask the clinic or hospital where you receive your Reclast infusion if they will accept a SingleCare Reclast coupon; you could pay only $53.21 for 1, 100ML of 5MG/100ML Bottle of generic Reclast.

What is the secondary code for Chapter 20?

Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.

When will the ICD-10 T50.4X5A be released?

The 2022 edition of ICD-10-CM T50.4X5A became effective on October 1, 2021.

What is zoledronic acid used for?

Zoledronic acid is indicated for the treatment of: Bone metastases from solid tumors in conjunction with standard antineoplastic therapy , including bone metastases from multiple myeloma, breast carcinoma, prostate carcinoma, and other solid tumors.

What is C88.2 C91.62?

C88.2 – C91.62 – Opens in a new window Heavy chain disease – Prolymphocytic leukemia of T-cell type, in relapse

What is C38.8?

C38.8 Malignant neoplasm of overlapping sites of heart, mediastinum and pleura

What is the procedure code for intravenous infusion?

Intravenous administration by infusion should be billed with procedure code 96365 for first hour and procedure code 96366 for each additional hour. If the administration is by IV push, use procedure code 96374.

What is the code for low bone mass?

To report low bone mass for procedure code J3489 use diagnosis code M81.0 - Age-related osteoporosis without current pathological fracture. For codes in the table below that require a 7th character, letter A initial encounter for fracture, D subsequent encounter for fracture with routine healing, G subsequent encounter for fracture with delayed healing, K for subsequent encounter for fracture with nonunion, P for subsequent encounter for fracture with malunion, or S sequela may be used.

What is the HCPCS level 2 code for reclast?

The appropriate HCPCS Level II supply code for Reclast® is J3489 Injection, zoledronic acid, 1 mg.

Can you bill hydration infusions separately?

Billing for hydration in combination with other infusions is a common source of confusion. Hydration of 30 minutes or less is never separately billable. Nor may you separately report hydration if it’s performed concurrently with administration of a drug.

What is an unlabeled drug?

An unlabeled use of a drug is a use that is not included as an indication on the drug's label as approved by the FDA. FDA approved drugs used for indications other than what is indicated on the official label may be covered under Medicare if the contractor determines the use to be medically accepted, taking into consideration the major drug compendia, authoritative medical literature and/or accepted standards of medical practice. The following guidelines identify three categories in which medications would not be reasonable and necessary according to accepted standards of medical practice.

Is oral injection considered a preferred method of administration?

Injection Method Not Indicated – – Medication given by injection (parenterally) is not covered if standard medical practice indicates that the administration of the medication by mouth (orally) is effective and is an accepted or preferred method of administration.