1. E

    Question Why was I marked wrong? (Practicode Case ID: OPD7205)

    The documentation: Why is 96372 reported in addition to J0696, which already specifies that the drug was injected?
  2. A

    Question How to bill a IV injection that the Sallie does not belong to us?

    My doctor found out the IV Sallie we had at the office was expired, so he borrowed a new pack from another doctor office next door and performed the injection. Can I bill the drug since we don't own it? Thank you.
  3. S

    Z79.899 Coding long term meds

    Hi everyone, I'm just looking for some additional clarification on billing Z79.899. I always thought you bill Z79.899 whenever a patient has a long term medication that does not have a more specific code (ie insulin, warfarin, metformin etc) However, I thought I remembered seeing somewhere that...
  4. S

    Question Billing drugs and supplies for Office Based Anesthesia (MAC)

    Good Afternoon, I have a question about billing guidelines for supply codes and Anesthesia billing. My Pain doctor uses CRNA's to provide OBA for facet injections and MBB. The CRNA wants to bill for the Drugs (Porpofol-J2704/Fentanyl-J3010/Versed J2250). They are adding the drug code to the...
  5. A

    Independent Laboratory Billing Place of service code

    Hello! We are an independent lab running lcms(80307) and definitive(G0480-G0483) billing for urine collected at the facility the patient is receiving care from and sent to us. United Healthcare (UHC) just started denying our claims for box 24B and box 32. We have always billed with POS 81 in box...
  6. J

    Do the codes 78812 and 78815 include administration of the drug?

    Do CPT codes 78812 and 78815 include the administration of the drug used for imaging with the PET scan? The description doesn't specifically say so. And if it doesn't - would you include the administration codes from the 96XXX series for the administration of the drug? Thanks in advance!
  7. J

    Billing for a drug with 2 NDC #'s

    Occasionally when I am coding the infusions in our office the drug will be pulled from 2 vials with different NDC#'s. When entering the information for billing there is only room for 1 NDC. Below is an example: OXALIPLATIN (J9263) 40ml comes from - 63323-0212-20 Oxaliplatin 5 mg/mL 20 mL...
  8. J

    Coding/Billing infusion drugs with 2 NDC#'s.

    Occasionally when I am coding the infusions in our office the drug will be pulled from 2 vials with different NDC#'s. When entering the information for billing there is only room for 1 NDC. Below is an example: OXALIPLATIN (J9263) 40ml comes from - 63323-0212-20 Oxaliplatin 5 mg/mL 20 mL...
  9. J

    Drug screening and confirmation

    We perform drug screen on our patients, and then repeat the screening to confirm results. Some of the codes we use are G6042, G6031, G6053. To be paid for both the screening and the confirmation, should we bill, for example, G6042 and G6058, Drug confirmation, each procedure; and G6031 and...
  10. Walker22

    Definitive Drug Testing for Cigna

    Cigna has recently released a drug testing policy that allows 8 definitive tests per date of service. Due to this limitation, they have determined that G0482 and G0483 are not medically necessary (because both codes exceed the 8 test maximum) and not payable. My lab now has a coding dilemma: 1...
  11. K

    Drug Screen 80300/G0477

    If your OB/GYN is screen for drugs for his pregnant patients with a "cup" screen of 10-12 different drugs. I wanted to know what diagnosis you would use if the patient has no prior use or even suspected use of drugs. Would you just code the Z36? if the "cup" shows a positive for one or more...
  12. D

    Coding a Drug Screen

    I'm trying to figure out how to code drug screenings now when physician wants to do a drug screen on a patient. do they need to code specifically what drugs they are screening for or can they use something like Behavior Disorder (F91.9)? They are so used to using V58.69 but ICD does not have a...
  13. B

    Billing Procedure for Sobxone Treatment

    I need assistance with the CPT code(s) that would be used for Drug Addiction Therapy. Our office will shortly begin using Suboxone therapy for treatment of drug addictions. What CPT code would be used for the Assessment which will include an Initial Comprehensive History and Physical, the...
  14. L

    Urine Drug Screen billing for Monitoring in a Residential Substance Abuse Setting

    Can someone help on guidance for UA's that are sent to an outside lab for processing? The requisition is marked for the monitoring of suspected substances and included with specimen. Is it appropriate for us to bill for these services if we pay the lab directly for furnishing the supplies and...
  15. A

    HELP! 2016 in house drug screen g0477

    Help! Medicare along with other insurance companies are not paying the new G0477 in house drug screen code. Anyone having same issue?
  16. L


    We are getting denials for code G0477 which took place of G0434. This is the urine drug screening. Has anyone else experienced this? The dx is Z79.899
  17. C

    Physician Billing for Drug screens in 2016

    I bill for a pain management office who routinely perform in office (cups) drug screening for patients on RX narcotic meds. We would normally bill G0434-QW for such tests, but now I'm getting rejections for this. I know CMS did away with this code and replaced with several others. I started...
  18. N

    infusion scenario

    I am going over coding scenarios for ED infusion and injections. Documentation from the ED Physician Notes: Administered Medications: •19:21 Drug: Zofran 4 mg Route: IVP; Site: left antecubital •20:54 Follow up: IV status: Completed infusion Response: No adverse reaction; Nausea is decreased...
  19. Colliemom

    Remicaid infusions

    Hi guys, I was hoping someone could help us. A patient came in for a Remicaid infusion. The drug was mixed, and the infusion started. During the infusion the patient had a reaction and the infusion had to be discontinued. Because the drug was already mixed, the remaining infusion had to be...
  20. B

    Drug Screening- have been calling

    I have been calling on VOB's and a few of the insurance companies are not recognizing the G0478 drug screening code , yet they are saying the G0431 is still a billable code. It was my understanding the G0431 was a deleted code as of 2016. Anyone else running into this problem ?
  21. T

    Urine drug screens in office

    What diagnosis would we use for a urine drug screen being done for state mandated screening of patients on narcotics? We are going to bill the new code G0477 and thought about dx Z51.81, however we were unsure if that dx could only be used by labs. Any advice? Thanks, Anna Sanders Tennessee
  22. R


    Is anyone dispensing the new Neupogen replacement drug Zarxio? Our doctors are looking into it and the drug rep said "everyone" is using it and "no one" is having reimbursement issues (sales pitch or what). So far haven't found any other practices using it.
  23. S

    Intolerance to drug VS adverse effect

    Would anyone code an intolerance to a drug as having an adverse effect? (would you use the table of drugs for that?) Just need a second opinion..
  24. K

    Drug Testing Coding

    Hello All- I am completely new to pain management, other than coding for epidural injections. We recently hired a Pain Management doctor and he started doing in office drug testing with "point of care" cups. I am not entirely sure how to bill them, the rep said we can bill medicare with code...
  25. K

    urine drug screening with an analyzer

    We are a pain management practice looking to purchase or lease a desktop analyzer to complete our urine drug screenings. I have some concerns about reimbursement from various insurance carriers. Can anyone let me know exactly what the reimbursement is for the screening test? I can get Medicare...
  26. N

    E&M level for over the counter drug

    For ER physician, if the history and exam are expanded problem and the physician gives an over the counter drug is that a level two 99282? What if the physician does not mark what type of drug was given but a prescription was given with and expanded problem history and exam? is that a level...
  27. T

    Billing for IV Push in Preop/Recovery

    If there is anyone who codes for ambulatory surgery I am having a problem. I have been told that when drugs are administered by our nurses in preop or recovery for anxiety or for pain control that the drug can be billed but not the administration of it. Does anyone know?
  28. K


    I have been out of billing for injections for awhile and now I have a question. If you have a drug that is covered by Medicare and the allowable is less than cost can you file with the invoice or does anyone have any suggestions? We have tried having the patient pick the drug up at the pharm but...