How to bill Bi Lateral Penicillin Injections

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Can some one please help me to understand Bi Lateral Injections? Report is as follows:


*Start Penicillin G Benzathine Suspension, 2400000 UNIT/4ML, as directed, Intramuscular, once in clinic, 30 days, 4 mL, Refills 0

Therapeutic Injections
Penicillin : 2 mL (Route: Intramuscular) (Positive RPR test)
Penicillin : 2 mL (Route: Intramuscular) (Positive RPR test)
Procedure Codes
Penicillin
J0561 INJECTION PCN G BENZ 100000 UNITS
 

thomas7331

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The intramuscular injection CPT code 96372 is not a code that most payers will accept as a bilateral procedure because it is not a site-specific code that corresponds to a bilateral body part, so I would bill this as 96372 for the first injection and then 96372-59 (or 96372-XS) for the second one.
 

SharonCollachi

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2,400,000 UNIT/4ML = 600,000 units per ML.
J0561 INJECTION PCN G BENZ 100,000 UNITS. This means you will bill a quantity of 6 for each ml. (units per ML divided by units per hcpcs)

If you use the entire 4ml vial, you will bill 24 units total.
 
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West Valley, UT
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2,400,000 UNIT/4ML = 600,000 units per ML.
J0561 INJECTION PCN G BENZ 100,000 UNITS. This means you will bill a quantity of 6 for each ml. (units per ML divided by units per hcpcs)

If you use the entire 4ml vial, you will bill 24 units total.
Ok this is starting to make more sense so just to be clear correct coding would be?

J0561 @ 6 units ( because it is bi lateral)
J0561 @ 6 units
96372
96372 Mod 59
 

SharonCollachi

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There is no bilateral for penicillin injections. You're not injecting into a joint or anything that requires a specific location on the body.

It looks like you used the entire 4 ml vial, according to your initial information, so it would be 24 units total.

I have never tried to bill more than one unit of 96372; I can't imagine anyone would pay the second one but you never know. Just for curiosity's sake, why would you split the injection into two? It's only 4mls, it's not like it's 30 mls or something huge. But I also don't understand why you're injecting penicillin for a positive syphilis screen, instead of doing a confirmatory test. Maybe times have changed.

I would bill J0561 x 24 units, and 96372 x 1 unit.
 
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