Wiki Histafed Injection

Create Wiki
C

cycle47

Guest
Messages
12
Best answers
0
Histafed aka Bromphneramine injection is being denied with HCPCS code J0945. Insurance states this is OTC rx and physicians should not bill....they state there is a more
appropriate code available for Histafed. Per HCPCS, J0945 is correct. Any ideas on how to get the injection paid/approved?
 
The information I have is that this is classified as a self administered drug. This is designated in the HCPC book as such. Perhaps this is why the denial. What dx code are you giving it with and what is the circumstance for the office to be the once administering the injection.
 
Histafed inj

Patient presents with sinus infection,etc and it is decided to give them the injection of histafed. Dx falls under sinusitus.
 
Ah I looked futher, this is not an injectable it is an oral medicine it is not administered as an injection at all. This is why it is denied as OTC.. Are you certain it was an injection the physician gave? or does he just state that the drug was given.
Active Ingredient: brompheniramine maleate
Dose Form Descriptions: liquid; powder; solution; tablet
Route Descriptions: compounding, oral
Brompheniramine Maleate Strength Descriptions: 10 mg/mL; 2 mg/5 mL; 4 mg
 
Histafed

Brompheniramine maleate code j0945 per hcpcs is a injection and is approved by medicare as not only self administered for long-term use patients but acceptable for physician/nurse to administer for acute care patients who would not nomally give themselves an injection.

It is given subcutaneously.
 
You may have to appeal then the only information I could get to come up all pointed to oral suspension for this drug. Did you also bill an admin code to show injection? also the Medicare listing I have that has this drug listed shows a 0.00 dollar allowable. Very confusing.
 
You must log in or register to reply here.
Top