Wiki 96372 for prepurchased Stelara

[Texascoder64]

Does anyone know about Stelara injection billing. We have pts that purchase their Stelara through their pharmacy and gets shipped to our office. Our MA's just do the injection. The patient has already paid for the medicine. Would the physician's office only bill 96372 admin code only? - I was told that you have to bill the J3357 that you can not bill the admin code alone and have to report the Jcode - but it does not seem right if the patient has already purchased the medicine.

which way is correct to report it on the claim?

thank you

Lisa

 

[marina@medibright.com]

you are correct, you have to bill only 96372

 

[Kisalyn]

Agree. Some of our patients supply their own meds. They get them from places cheaper like the VA. We can only bill out the injection administration.