gcohen
Guru
I have a denial, requesting the J code of the medication. As we did not supply the medication, only administer, why should we code the medication?
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Wiki 96372
- Thread starter gcohen
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SharonCollachi
Guest
Because they want to make sure it's not dry-needling, which is usually considered experimental and therefore not covered. Just code it with a zero dollar amount, or if your system won't allow that, code it as one cent.
thomas7331
Guest
Yes, it's also because the payer can't determine whether or not the service is a covered benefit if they don't know what drug or substance was administered - if the drug isn't covered, then the injection won't be covered either. It's standard practice for providers to identify the drug with a zero dollar or one cent charge if the provider didn't purchase the drug.
bergpws
New
Bill the drug code and charge .01. We do this all the time. They want to know the drug given.
gcohen
Guru
ok thanks everyone.
If you are billing Medicare, they require you report the drug with .01 but also GY or GZ modifier, billed as non covered, as Medicare does traditionally reimburse even if you are billing less than reimbursable amount.