Advanced Search

Primary Care Coding Alert

READER QUESTIONS :

Supervision Situation Alters Xolair Admin Coding

Published on Sat Jun 06, 2009

Question: An established 19-year-old patient with allergic asthma reports to the FP for a scheduled Xolair injection. A qualified nonphysician practitioner (NPP) injects the patient twice with 50 mg of Xolair. Can I report an injection code for this, or is it considered an E/M service since an NPP performed the injection? Georgia Subscriber Answer: Your code choice will depend on what role, if any, the FP had in the encounter. Option 1: If the FP provides direct supervision during the encounter, then you should report the following: " 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) for the first Xolair injection " 96372 for the second injection " Modifier 76 (Repeat procedure by same physician) appended to the second 96372 " 493.90 (Asthma; unspecified) linked to all the injection codes to represent the patients condition " J2357 (Injection, omalizumab, 5 mg) x 20 for [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Primary Care Coding Alert

View All