jordev0308
Guest
- Messages
- 1
- Best answers
- 0
When a patient is prescribed Praluent and brings the injection to the office for a nurse to administer do we bill a biologic admin or a therapeutic admin?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Biological administration vs. therapeutic
- Thread starter jordev0308
- Start date
danskangel313
True Blue
- Messages
- 809
- Best answers
- 0
From what I've read, I believe it depends on the payer.
I wasn't familiar with what that med is, so I looked it up and included with the description was "This code represents the supply of the drug. Check coding and individual payer guidelines to determine whether you can also report the administration of the drug." It did keep referring me to 96372 for the administration instead of a nurse visit arguing the type of drug called for more supervision, best represented in 96372. I have no idea if that's actually the correct way to do it.
You'll likely have to add additional info in what would be the equivalent to box 19 and a found a lot of payers also required a modifier when situations like this arise (not specific to Praluent).
I wasn't familiar with what that med is, so I looked it up and included with the description was "This code represents the supply of the drug. Check coding and individual payer guidelines to determine whether you can also report the administration of the drug." It did keep referring me to 96372 for the administration instead of a nurse visit arguing the type of drug called for more supervision, best represented in 96372. I have no idea if that's actually the correct way to do it.
You'll likely have to add additional info in what would be the equivalent to box 19 and a found a lot of payers also required a modifier when situations like this arise (not specific to Praluent).