Billing 67028 when a sample drug is used

mihill

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Just curious how others are handling CPT 67028 when a sample drug of anti-VEGF is used? Do you bill insurance or not for 67028? Does it depend on the reason a sample is used?
Thank you for weighing in.
 

saddie2k

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If the drug is normally covered for the diagnosis but sample used for the initial visit then you bill the injection code to insurance. If the drug would never be covered for the diagnosis then it would not be payable by the insurance plan.
 

mihill

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What if a sample is used because the drug is provided too soon according to FDA guidelines, does anyone bill insurance for the 67028?
 
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