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Wiki Faslodex, two injections
- Thread starter dtricia
- Start date
vpriya@scioms.com
Contributor
Hi Tricia,
We are billing Faslodex with admin (96402) in two separate line items as 96402 -mod (59) and in second line item 96402- mod 59,76.We are getting paid from Medicare.
Please let me know if you have questions.
Thanks,
Priya
We are billing Faslodex with admin (96402) in two separate line items as 96402 -mod (59) and in second line item 96402- mod 59,76.We are getting paid from Medicare.
Please let me know if you have questions.
Thanks,
Priya
CancerCenter
New
Can we not enter 96402 x 2?
jrs7117
Networker
Faslodex
I thought that if there were multiple injections of the same drug we were only to code one admin code. I have a few injectible drugs like that,
Faslodex- i use 96402 (with 2 vials injected)
Irwinia - i use 96401 (With up to 5 vials injected)
Vidaza - I use 96401 ( with up to 5 vials injected)
Can someone tell me if I am doing this wrong?
Any insight is helpful.
Julie Williams
I thought that if there were multiple injections of the same drug we were only to code one admin code. I have a few injectible drugs like that,
Faslodex- i use 96402 (with 2 vials injected)
Irwinia - i use 96401 (With up to 5 vials injected)
Vidaza - I use 96401 ( with up to 5 vials injected)
Can someone tell me if I am doing this wrong?
Any insight is helpful.
Julie Williams
OncologyOKC
Networker
If you are having to split the injection then you would bill 2 administration codes as long as the nurse has documented that they were each done at a separate time in a separate location. You can also see the answer in this link from HCpro.
http://www.hcpro.com/print/REV-230459-859/QA-One-injection-code-or-two.html
It would depend on carrier preference if you were to bill separate lines or just use units.
I see no reason at all that you would be using the 59 on the 1st 96402 and then a 59/76 on the second. Unless you were doing another type of chemotherapy infusion that day (which I do not see in my practice at all) we sometimes will bill the Faslodex on the same DOS as Xgeva but still the initial 96402 would not require a 59 modifier.
http://www.hcpro.com/print/REV-230459-859/QA-One-injection-code-or-two.html
It would depend on carrier preference if you were to bill separate lines or just use units.
I see no reason at all that you would be using the 59 on the 1st 96402 and then a 59/76 on the second. Unless you were doing another type of chemotherapy infusion that day (which I do not see in my practice at all) we sometimes will bill the Faslodex on the same DOS as Xgeva but still the initial 96402 would not require a 59 modifier.