Wiki 96372 testosterone denials

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tnash65

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Wilmington, NC
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Good morning, I am in NC and new to urology and have several denials for this code when a patient brings in their own medication. I know I can't bill a 99211 if no other issue is documented. Does anyone know how to bill this code to BCBS of NC for reimbursement without having to use our supplies and time for free? Thank you!!!
 
When we do testosterone only injections, and the patient brown bags it to our office, we only bill CPT 96372, and HCPCS J1071 with a zero dollar amount on the drug. This indicates to the insurance payor what was injected, and the quantity, and NDC info. This may be why you are seeing denials.
 
julieordway said:
When we do testosterone only injections, and the patient brown bags it to our office, we only bill CPT 96372, and HCPCS J1071 with a zero dollar amount on the drug. This indicates to the insurance payor what was injected, and the quantity, and NDC info. This may be why you are seeing denials.
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Thank you so much!!!! We are going to try that.
 
Hi TNash65 :)
Are you billing the definitive dx as E29.1 or N52.9? Or whatever is assigned as medical necessity dx code by the doctor first , then the injection J1071 (the amount) and 96372? Are you putting the attending physician who order the injectable on the claim? This may help your denial problem to lessen
I hope helped you somewhat
Lady T.:)
 
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