coding Injections, Admin. and office visits

robinkea

Guest
Messages
10
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0
Hey,
Can anyone give me information on billing 99203-25, 96372 and J1885. I'm being told by the office that's biling it that 96372 is being denied. These are commercial carriers that are doing this. Is there somwhere that I can find the rules for this in writing?:confused:
 

pamtienter

Expert
NAB Member
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348
Location
Mound, MN
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Someone should check with the insurance company on the reason behind the denial. The 25 modifier is on the E/M so it all should be paid but maybe there is another reason?
 

mitchellde

True Blue
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13,426
Location
Columbia, MO
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1
It should not be denying I agree check with the carrier on this.. CMS had a transmittal on this I believe it was july of 06 it may have been 05, where they stated it was incorrect to bundle the injection admin with the office visit when a 25 was appended to the OV.
 

rthames052006

True Blue
Local Chapter Officer
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1,905
Location
York, Pa
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Hey,
Can anyone give me information on billing 99203-25, 96372 and J1885. I'm being told by the office that's biling it that 96372 is being denied. These are commercial carriers that are doing this. Is there somwhere that I can find the rules for this in writing?:confused:
I believe this is one of those things that falls under "carrier descretion" I would start making a list of these carriers who are denying and then making phone calls to your provider reps for these insurances just to get clarification.


I have 2 insurances that I deal with on a regular basis who will not pay th e96372.

Good luck~!
 

Karolina

Guru
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216
Location
Boston, MA
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Definitely call them and make sure it's not a "glitch". Years ago I had that with one of my carriers, different codes though, and each time I called they had to override the system. I was told there was a glitch.
 
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