BCBS 96372

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Normally if the patient brings their own injectable medication or it comes from a specialty pharmacy, you can bill 96372 alone without the J code for the drug injected. However, we are starting to get denials on 96372 from BCBS that a qualifying procedure is needed. Is anyone else getting these? If so, is it wanting a J code still on the claim?

Thanks!

Cathy
 

skiboi

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48
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Twin Falls, ID
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You still have to bill the J code as a no charge or one cent charge in order to indicate why you're billing the administration code.
Rachael thank you, this answers a post I just posted in regards to a sample of Ajovy, to me it seemed as though this should be done (reporting the free sample) to 'paint the picture' to the payer. Thank you. Jeffrey
 
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