Question 1

What is HCPCS code J0138?

Accepted Answer

HCPCS code J0138 is "Inj acetaminoph 10mg/ibu 3mg". Injection, acetaminophen 10 mg and ibuprofen 3 mg

Question 2

What category is J0138 in?

Accepted Answer

J0138 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J0138?

Accepted Answer

Use J0138 when billing for inj acetaminoph 10mg/ibu 3mg. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is J0138 covered by Medicare?

Accepted Answer

Coverage for J0138 (Inj acetaminoph 10mg/ibu 3mg) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for J0138?

Accepted Answer

Documentation for J0138 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).