E/M with 96372 - Would I need to use a modifier

dsmith06351

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Would I need to use a modifier on an E/M service when billing the 96372 injection code? Here is the scenario, A child comes in and the doctor dx otitis media the doctor then decides to give the patient an injection of rocephin we are billing the 99213 the j code for the rocephin and the 96372 for the administration but our E/M services are being denied stating that they are inclusive of the 96372.

Any help would be appreciated

Denise Smith CPC, CEMC
 

btadlock1

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Just to clarify, you would need a 25 modifier on the same DOS as 96372 in any situation that allows you to bill both. Vaccine admin codes don't create the need for a E/M modifier, but therapeutic/prophylactic injection admins do. Hope that helps!
 
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