If a pharmacist is mixing or compounding albuterol and ipratropium, should the pharmacist still use J7621?
A. No, J7621 is only used for compounded drugs that are prepared by the manufacturer. In cases where the pharmacist is mixing the two drugs together, the supplier will need to bill the drugs using code J7619 for albuterol and J7644 for ipratropium with the appropriate modifier KP, or KQ as described in the Nebulizer LCD Q5. The number of allowed units for DuoNeb (J7621) is not indicated in the LCD. Providers were informed that the usual utilization for J7621 was set at 60 units of service per month. This seems low when compared to the expected utilization of albuterol (J7619). Can you explain this difference? A. The expected utilization for DuoNeb (J7621) was set based on a four times per day dosage schedule. It was subsequently determined that albuterol (J7619) expected utilization was based on a six times per day dosage schedule. The number of allowed milligrams (mg) for albuterol (J7619) specified in the Nebulizer Local Coverage Determination (LCD) is 465 mg per month. The number of
