Wiki 96523 w/ j1642

[heidi3]

Can you bill these together if that is the only thing done at that day

 

[OCD_coder]

You can never bill Heparin with anything. It is bundled into the chemo work, whether your billing for flushes or infusion.

96523 is a stand alone code, nother can be billed with it.

It has to be done and it is not given for therapeutic reasons.

 

[torresjeffreyp@gmail.com]

Hi,

can we use mod 59 to J1642 when it is billed with 96413? The insurance is telling me that I need to append a modifier to it but I am not sure if modifier 59 is appropriate. Thanks

 

[trarut]

OCD_coder's response from 2011 above still applies. The heparin is a bundled service in relation to the chemotherapy administration and is not separately billable with or without a 59 modifier.

 

[CodingKing]

heparin will be bundled until the end of time. Its a standard supply and included in the RVU calculation of any procedure involving IV access.

 

[EBONIMOBLEY]

UH denied CPT Code 96523 for missing the primary procedure code I'm a little confused because this code is a stand alone code should this code be billed with a Primary Code

96523​

 

[thomas7331]

UH denied CPT Code 96523 for missing the primary procedure code I'm a little confused because this code is a stand alone code should this code be billed with a Primary Code

96523​

You're correct, it does not require a primary procedure. Either they denied it in error, or they denied it with the wrong reason code.