Failed Injection J2505 Neulasta

rkott02

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I need assistance with the following scenario, trying to determine the most appropriate way to bill.

We have a patient that had a Neulasta OnPro injector placed on 2/19/19 and it happened to malfunction (the patient actually received no drug)the device leaked, the subcutaneous cannula did not insert properly to inject the drug. She came back the following day 2/20/19 and we had to administer a Neulasta injection given the malfunction. Both administrations were documented on the MAR. How do we ensure that the patient is not charged for the injection that malfunctioned? Do we have to charge it twice?

We currently have a claim for 2/19/19 billing for both HB and PB.
HB claim includes J2505
PB claim includes 96377


We have not completed the coding for the 2/20/19 claim as of yet due to the confusion of what to bill on each claim. My assumption would be that we would have to write off the 2/19/19 claim due to the malfunction.

• Since the patient did not receive the medication, and since it was repeated on 2/20, how would this be handled on the billing end to ensure the patient does receive a bill for the repeat injection?

Any assistance is greatly appreciated!

Thank you!
 

jbrandt

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Failed Injection

Hi,
If the NOBI (Neulasta On Body Injector) failed regardless of how it failed (patient error or malfunction), you cannot bill for either the NOBI or the administration (J2505, 96377). You would only bill a claim for the Neulasta shot the patient received when they came in after the malfunction (J2505, 96372). When the patient notifies our office about the malfunction they are instructed to bring the NOBI with them & to come in for the shot. The infusion/chemo RN then notifies billing that the NOBI malfunctioned so billing can take care of the claim situation. The charge RN then notifies the pharma company & sends in the malfunctioning NOBI for replacement. I hope this helps!
 
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