Wiki Botox vial shipped from patient's pharmacy

[Texascoder64]

I need clarification on when billing medical botox injections, for example, hyperhidrosis, and the vial is shipped to practice from patient's specialty pharmacy. Would the only CPT be the admin - 64650 and not J0585 x100? My thought is that the cost was already paid to pharmacy for the vial(s) and if it is on the provider's claim, wouldn't that be duplicating?
Either I am confused or the provider is confused, but I thought if J0585 is provided by the practice's stock, then that is when J0585 would be billed to insurance with Admin 64650.

 

[TTcpc]

I need clarification on when billing medical botox injections, for example, hyperhidrosis, and the vial is shipped to practice from patient's specialty pharmacy. Would the only CPT be the admin - 64650 and not J0585 x100? My thought is that the cost was already paid to pharmacy for the vial(s) and if it is on the provider's claim, wouldn't that be duplicating?
Either I am confused or the provider is confused, but I thought if J0585 is provided by the practice's stock, then that is when J0585 would be billed to insurance with Admin 64650.

We've had situations in the past where the insurance company wanted the drug on the claim even if it was supplied by their specialty pharmacy to indicate what was administered that day - you would think they would know since they supplied; however it is sometimes done via a separate division. Since our system won't let us put a $0 charge, we put it on at $0.01 and do a small charge write-off.
Some payers don't require it....just a matter of what each payer wants on the claim.