jordev0308
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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?
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Wiki Biological administration vs. therapeutic
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danskangel313
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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).