Wiki Billing E/M with 96372

[rebec26@juno.com]

A patient comes in for office visit because they have a rash. The physician performs a complete exam and diagnosis patient with poison ivy. He gives an injection of a steroid. Do you bill for the E/M and the injection or injection only?

 

[ehanna]

I would bill for the exam and the injection with a -25 modifier on the exam. He should get credit for his exam and decision making. I hope this helps

 

[rebec26@juno.com]

Thanks. We agree. For compliance reasons do you happen to know of any reference material to support this?

 

[krisw7067]

You would bill E/M with -25, the J code for the med and then 96372 for the injection. Don't forget to bill the med!!!

 

[Amy Pritchett]

Yes! You are within compliance guidelines to bill the injection (96372) with the office visit as it is a significantly identifiable procedure performed on the same date as an evaluation. Also, do not forget to bill the HCPCS code(s) for the medication given

Hope this helps