Question 1

What is HCPCS code J0153?

Accepted Answer

HCPCS code J0153 is "Adenosine inj 1mg". Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)

Question 2

What category is J0153 in?

Accepted Answer

J0153 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J0153?

Accepted Answer

Use J0153 when billing for adenosine inj 1mg. 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

What ICD-10 codes are commonly used with J0153?

Accepted Answer

Common ICD-10 diagnosis codes used with J0153 include: A18.84 (Tuberculosis of heart), A36.81 (Diphtheritic cardiomyopathy), A39.53 (Meningococcal pericarditis), A40.0 (Sepsis due to streptococcus, group A). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is J0153 covered by Medicare?

Accepted Answer

Coverage for J0153 (Adenosine inj 1mg) 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 6

What documentation is required for J0153?

Accepted Answer

Documentation for J0153 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).