Billing for Medications Brought into Office by Patient

[tburdette]

Need guidelines for Billing the medications brought into an outpatient setting by the patient and administered in the office.

[sbicknell]

code the 90000 administration codes. Can not code for the drug since patient is bringing their own

If documentation supports, could also code 99211-25 but only if an additional separate service is provided.

If they are there for a planned, scheduled injection, then code only the injection code(s)

[tburdette]

Thank you very much for your assistance. We have payors that will not pay the administration codes without the medication listed. Would we bill the medication with a GY Modifier?

[sbicknell]

I dont see that mod -GY would be appropriate.

If they are denying the administration because no J code is coded, I would suggest coding the administration code with regular charge. And then also code J3490 (unlisted drug) with a charge of .01 cent

See what other responses you get

[tburdette]

Thank you, I think I can push that through our system.

[ANGELAMM2004]

You need to put the name and amount of the drug in the comment section.