Colliemom
Expert
Good morning,
I am hoping someone can help with billing for Stelara. One of our providers is asking the following questions:
We were told, right from the manufacturers website that we should bill Stelara as 96365. And our provider is questioning how this can be correct, as we bill 96413/96415 for Remicade and Entyvio. He feels that this can’t be right, as Stelara is also an infusion.
"Why are we billing 2 biologics one way and 1 biologic differently? Although they are different mechanisms of action, they are all 3 essentially the same idea. Why are we not billing Entyvio and Remicade as 96365?"
thank you in advance
I am hoping someone can help with billing for Stelara. One of our providers is asking the following questions:
We were told, right from the manufacturers website that we should bill Stelara as 96365. And our provider is questioning how this can be correct, as we bill 96413/96415 for Remicade and Entyvio. He feels that this can’t be right, as Stelara is also an infusion.
"Why are we billing 2 biologics one way and 1 biologic differently? Although they are different mechanisms of action, they are all 3 essentially the same idea. Why are we not billing Entyvio and Remicade as 96365?"
thank you in advance