• 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 your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

botox injection for anal fissure

skm510@live.com

Networker
Messages
56
Best answers
0
We have been coding this as 46505 for sometime... it was recently brought to my attention that many carriers are not paying for lack of a J code. My question is... Can I bill the J code if the hospital is supplying the Botox? Any help would be greatly appreciated.
 

mjewett

Guru
Messages
202
Location
Johnson City
Best answers
0
Nope, the rule thumb is if you didn't buy the supply you can't bill for it.

I would instead try sending on the claim a note to the insurance carrier stating (botox was injected) Don't bill for the J-Code but its ok to tell them what you used.

On a side note with 5010 conversion they changed the path for sending verbiage electronically on the claim to ins. carriers. If you have trouble with this I would contact you software vendor.
 
Messages
4,466
Location
Milwaukee WI
Best answers
0
But .... the faciliyt MUST bill the supply

We recently had some issues with this. Discovered that the hospital was not billing for the botox (i.e. the supply). Insurance was basically saying there was no proof the drug was injected.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
Top