Dexamethasone Sodium Phosphate

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Joined: Sat Dec 20, 2014 9:32 pm

Thu Oct 18, 2018 1:38 pm


We are wondering if anyone else is having trouble when billing for this drug. The administration routes for J1110 state IM, IV, OTH. We are presuming the "OTH" means oral. We have been having issues with our providers dropping a J8540 as it says oral, but charges are denied as this form is a chemo related drug. The drug name for J8540 is just Dexamethasone, J1110 is Dexamethasone Sodium Phosphate - which appears to be two completely different drugs.

Our question - is J1110 appropriate and billable for oral use?

Thank you in advance for any help.

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Thu Oct 25, 2018 9:40 am

J8540 Dexamethasone, oral, .25 mg

“The corticosteroid dexamethasone works in the body to control inflammation. One unit of this code represents 0.25 mg of dexamethasone. The route of administration is oral, which is given through the mouth.” “Brand names for this drug include: Baycadron Elixer, Decadron, Dekpak 13 Day Taperpak, Dexamethasone Intensol, DexPak, DexPak 10 Day TaperPak, DexPak Jr, Zema Pak.

J1100 Injection, dexamethasone sodium phosphate, 1 mg

“Dexamethasone sodium phosphate works to prevent the release of inflammatory substances in the body. One unit of this code represents 1 mg of dexamethasone sodium phosphate. Routes of administration include intramuscular, which is an injection into muscle; intravenous, which is an injection, or instillation of liquid, through a needle into a vein; subcutaneous, which is an injection under the skin; and other routes.” “Brand names for this drug include: Decadron Phosphate”

I copied the lay information from AAPC coder for each of the above. The “and other routes” refers to other routes of injection. Since you indicated they are dispensing for oral use, J8540 would likely be the appropriate code to report. Using the NDC number off the medication packaging and running it thru a quick Google search will allow you to definitively identify what HCPCS code is supported for the medication they are dispensing.

Your question has been answered by Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA
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