Urology Coding Alert

Question: A coworker thinks that when a patient brings a prescription drug, supplied by the patient, to our office for staff to administer, the urologist shouldn't code the medication administration, because the urologist did not buy the drug. If this is true, how can the practice receive payment for giving injections of patient-supplied medicine?


Arkansas Subscriber


Answer: You should report medication administration, regardless of who supplies the medication. The appropriate medication administration codes - for instance, G0351 (Therapeutic or diagnostic injection; subcutaneous or intramuscular) or G0356 (Hormonal antineoplastic) - reimburse you for your staff's time and the supplies (such as syringes) inherent in the procedure. 

Key: The administration codes do not include the supply of the drugs themselves. So when a patient supplies the medication, you omit billing the related supply J code.

To help insure payment from the carrier, note on the CMS-1500 form in box #19 (or in an electronic note pad) that the patient supplied the drug. Also note the name of the drug administered and its dosage. In many cases, carriers require this before they'll pay for an administration code when you have not also submitted a drug charge.