Wiki Depo Shot question

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ascordilis

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How do you bill for this shot when the patient brings it in themselves? If we provide it(by the nurse) who would it be billed? Thanks! Lisa!
 
Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present". I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co. :)


Karey, CPC
 
karey said:
Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present". I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co. :)


Karey, CPC
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Where do you see that?

The definition of direct physician supervision simply means that the physician is in the office suite. The physician does not have to be in the room physically observing the injection...
 
It says it in the CPT book under 96372.
You're right about direct supervision, this is saying if there is no direct supervision....in other words general supervision (the doctor has to be available) doesn't apply and wouldn't be acceptable.
 
What is Direct Supervision?

I took the definition below directly from CMS. Please remember that direct supervision does NOT mean the physician must be present in the same room.


Direct supervision in the office setting does not mean that the physician must be present in the same room with his or her aide. However, the physician must be present in the office suite and immediately available to provide assistance and direction throughout the time the aide is performing services.
 
Michalene Hoskins CPC

prior to 2009 we used 90772 for procrit injections. If the patient saw the physician the same day we could bill 90772and an E&M with modifier 25. Since the code changed to 96372 we are being denied payment for it if it is used with and E&M code. Does anyone know if you can't use both now? Still trying to get an answer from my local carrier Palmetto GBA.
 
karey said:
Be careful when using the new injection codes. It states "Physicians, DO NOT use 96372 for injections given w/out direct supervision by the physician. To report use 99211. Hospitals may use 96372 when the physician is not present". I have to use 99211-FP to bill Medicaid w/ all of our injections and have never had problems. So we'll see how it goes w/ all of the other Ins Co. :)


Karey, CPC
Click to expand...

The 99211 has beeen a very sticky and unclear code since arriving on the scene. I was wondering how this would apply to a medical assistant. Per CMS it specifes "Nurse. I am not sure if I applies to different states but Wisconsin will not pay for a 99211 for a MA.
 
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