Wiki Billing multiple codes

[ReneeGillam CPMA CMOM CMC]

I need a second opinion.

Patient comes to the office, Sees NP. NP charges a 99214, patient receives a Procrit injection J0885 plus injection fee 96372. patient also receives a B-12 injection J3420 plus the injection fee 93672.

How should this look on the claim?

 

[pwest8690]

99214 w 25 mod, J0885, J3420 and the injection fee - 96372 x 2 units.

 

[ReneeGillam CPMA CMOM CMC]

Patient has Medicare. Only thing I see is I would need to add the EC modifier to the drug code correct?

 

[ABridgman]

I have never had to add an EC Modifier to a B12 shot to get paid by Medicare or any other payer.

Now, for Aranesp/Procrit, I used EA, EB, or EC, as appropriate.
If it is subsequent, and not initial, you might use EJ.
But you should not use EJ for an initial treatment...nor should you use EJ as well as EA, EB, or EC.

I think you could also use just the EA, EB, or EC...for subsequent, as well as initial treatments.

The next part does not apply to your specific case, but, be careful if you are coding a NOC-type code, for example J3301 for Kenalog. That will get rejected without a line note.

The B12 and the Aranesp/Procrit should not be a problem in that regard. You should not need any line note for these.