96372 when patient brings in the medication

[yvonneflintdavis]

When patients come in for a b-12 or testoterone injection and bring in the medications, is it necessary to add the J-Codes for the meds at a ZERO cost on the claim? Or can we just add the admin codes with the approriate documentation attached to the claim for processing.. Thanks in advance for any guidance.

 

[Cynthia Hughes]

Under Medicare policy, the code for the drug administered must be billed with a zero cost. See Chapter 17 Section 70.2 of the Medicare Claims Processing Manual. Though this is specific to Medicare, other payers will likely have similar policies for purposes of verifying the medical necessity of the drug administration. Cindy

 

[yvonneflintdavis]

Thank you for the information, it is greatly appreciated!!