Wiki 90772 changed to 96372 for 2009


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I have a question in reguards to the description on these codes. It says that this code should NOT be billed without "direct physician supervision". Does this mean that the physician has to be in the exam room while the nurse gives the injection or does it mean he has to be in the building?
senior biller

no they do not have to be present in the room, phy in attendance in the office is how I understant the code.
I have a question about 90772 being changed to 96372.... Have you sumitted the new code to insurance carriers yet??? Medicare is not recongizing it...Does Physican have to be in the room??

Thanks for your help!!
I have billed the new 96372 and medicare is recognizing for us. It was effective 1/1/09, so if you have used it for DOS prior to that, then it will deny.

I got an eob yesterday and Medicare denied 96372 on my patient. DOS was 01-09-09 we are an Instant care center. Place of service 20. Do you guys think the POS has something to do with it???

update: Per Medicare's CSR 96372 cannot be used in a 20 place of service. Does anyone know where that is written?


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96372 ...which medicare carriea paid?

Hi Angela. To which Medicare(region) you billed 96372???
I assum they paid you instanlty as they were 90772 in 2008. We had no problem w/90772.
Our medicare carrier, Palmetto GBA, said need modifier 25
even with the E/M code we appended 25 modifer.
They said everything stated in Publication 100-04 CMP 12
section 34??? I check 100-04 nothing said.
Even I was told to check CR3192, CR3631, CR3818 & CR4032 (CR means "change request" per Palmetto), cannot find anything.
Could anyone give us the clear answer?