Wiki Chemotherapy Coding and billing Administrative and HCPC Codes

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klrioux

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When billing a chemotherapy claim do I stager the Administration code with the corresponding HCPC Code or can I list all J codes first then Administration codes after? Also do the HCPC Codes need to be entered by highest dollar drug first or does this not matter?
Examples 1:
96413
J9263
96417
J7060
96415
96411
J9190
96416
96375
J2469
96367
J1200
J2780
96368
J0640
96366

Example 2:
J0640
J2780
J1200
J2469
J9190
J7060
J9263
96413
96417
96415
96411
96416
96375
96367
96368
96366
 
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Example 1 lists 96368 twice, 96368 can only be billed once per encounter. In all of my years of billing, I've never reordered a claim like either of the examples and never had an issue. The only issue I ever encountered was if the administration codes ended up on separate claims then I would get rejections for missing "Initial" administration code or if there were 2 lines of the same drug, the 2nd line being the waste, I might receive a rejection for duplicate and would appeal, but no other issues.
 
cmoser3635 said:
Example 1 lists 96368 twice, 96368 can only be billed once per encounter. In all of my years of billing, I've never reordered a claim like either of the examples and never had an issue. The only issue I ever encountered was if the administration codes ended up on separate claims then I would get rejections for missing "Initial" administration code or if there were 2 lines of the same drug, the 2nd line being the waste, I might receive a rejection for duplicate and would appeal, but no other issues.
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Thank you for seeing that it should have been 96366 not 96368 klrioux
 
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