When coding and billing for J3490, Unclassified drug, submit the CMS 1500 form (click here to view the form) or its electronic equivalent with J3490 on the first line (Box 24) with 1 unit of service (UOS). In Box 19, enter the full name of the drug/product utilized, total dosage given to the patient and the National Drug Code (NDC code). This number is a 10- or 11-digit number that refers to the drug or product, strength and package size produced by a certain drug manufacturer.
For example, if 10 Testopel™ pellets are implanted in the patient, submit one line item with J3490 with one unit. Box 19 of the CMS form should read: Testopel, testosterone pellet, XXmg, NDC number XXXX-XXXX-XX.
For more information about using the unlisted drug code, contact the AUA’s Coding Hotline at 866-746-4282, option 2, or e-mail codinghotline@AUAnet.org.