Wiki Hyperhidrosis - Billing for Botox

Rinklefree

Guest
Messages
1
Best answers
0
We treated a patient with hyperhidrosis with Botox and billed Aetna cpt codes 64650 & 64653 which were paid. we also billed J0585 @ 200 units which Aetna ultimately denied.
The patients plan requires that they get the Botox through their pharmacy, so our office is not supplying the botox. Should we still bill J0585?
 
We always prescreen Botox for hyperhidrosis for a patient to see if coverage falls under their medical or prescreption benefits or if it requires a prior auth. More often than not, we are having the Botox filled through the patient’s specialty pharmacy and subsequently, we don’t bill the J code on the claim.
 
I agree you can't bill the botox, as the outside pharmacy provided the medication. Our hospital bills a Patient Provided medication with a charge code and a zero dollar amount.
 
Top