smatt58
New
Can you bill a 99211 when the patient supplies the medication i.e. B12 instead of 96372? We've started to receive denials.
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Wiki 99211 vs 96372
- Thread starter smatt58
- Start date
thomas7331
Guest
No, 99211 is an evaluation and management services and 96372 is an injection. They are different services with different definitions and are not interchangeable. You can only bill the services that are documented.
If you are receiving a denial, then the correct approach is to review the payer's policies, or discuss this with them to get an understanding of why this is happening.
If you are receiving a denial, then the correct approach is to review the payer's policies, or discuss this with them to get an understanding of why this is happening.
jbland
Guest
are you putting the "J" code on the claim with 96372 with a 0.00 cost? The claim will deny for not having the medication on the claim.
CatchTheWind
Guest
jbland, that is not correct - you can bill a 96372 without a J code (ie: when the patient brings their own medicine).
smatt58
New
Is anyone else receiving denials for 96372 for Anthem when patient supplies medication
SharonCollachi
Guest
I find many payers deny an injection when there is no medication indicated. I use a J code, a zero dollar (unless your software won't allow it, then use one cent) and in box 19, you put PATIENT SUPPLIED (NAME OF MED) FOR INJECTION.
Insurance companies now want the J code for the medication injected even though the patient supplied the medication. If the patient only came in for the injection and supplied the meds then 96372 with the J code with "zero" or " .01" if you can't put in zero dollars, should be on the claim as previously stated by Sharon C.