botox injection for anal fissure

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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

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Johnson City
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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.
 
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4,466
Location
Milwaukee WI
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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
 
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