Oncology & Hematology Coding Alert

Question: We used the EpiPen kit in the office on a patient who experienced an allergic reaction. How do we bill for using the kit?

Vermont Subscriber

Answer: Use of an EpiPen represents an injection of epinephrine. As such, it would be appropriate to code its administration using code CPT 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular).

The preferred HCPCS code may vary by payer, with some preferring J0171 (Injection, adrenalin, epinephrine, 0.1 mg) and others allowing J3490 (Unclassified drugs). If the payer allows J3490, be sure to follow its rules for reporting the code, such as submission of the national drug code and invoice to show the cost to your practice.

Tip: When reporting J3490, you should claim a single unit and report the drug and total dosage in the remarks field, according to Medicare's National Correct Coding Initiative manual, chapter XII, section F (available at www.cms.gov/NationalCorrectCodInitEd/).