aknoper
Contributor
Hello!
I'm sure (hoping) there is an easy answer to this but I cannot find it and when I call the payers they are no help. When I bill for a provider injection and the provider is using drugs from their stock we bill two codes; one for the injection and one for the drug. For example; A vitamin B injection is billed out as 96372 for the injection and J3420 for the drug. If I bill these two codes for a patient that has Traditional Medicare, Medicare pays on both codes just fine but if the patient has a Medicare Advantage plan they ALWAYS deny the drug code (J3420) and state that the code is covered by another payer even when the patient has a drug plan through that payer. It happens with all Medicare Advantage plans and I cannot figure out why they won't pay if Medicare pays just fine. Any ideas?
I'm sure (hoping) there is an easy answer to this but I cannot find it and when I call the payers they are no help. When I bill for a provider injection and the provider is using drugs from their stock we bill two codes; one for the injection and one for the drug. For example; A vitamin B injection is billed out as 96372 for the injection and J3420 for the drug. If I bill these two codes for a patient that has Traditional Medicare, Medicare pays on both codes just fine but if the patient has a Medicare Advantage plan they ALWAYS deny the drug code (J3420) and state that the code is covered by another payer even when the patient has a drug plan through that payer. It happens with all Medicare Advantage plans and I cannot figure out why they won't pay if Medicare pays just fine. Any ideas?