Wiki Injections and Modifiers

[ecaissie]

Hi! I'm billing for a recently opened clinic, and they tend to do a lot of injections, which I've never billed for before.

The most common treatment codes are 99204 for the new patient office visit, 96372 for the therapeutic injection, and J2010, J1885 and J1020 (1 cc each)for the injectibles. So here's how I've been coding it with modifiers:

99204-25
96372
J2010
J1885-59
J1020-59

Can anyone tell me if we will be paid separately for each injection? Or am I missing something? So far, the insurers have been Medicare and Horizon BCBS. Thanks!

 

[mitchellde]

was this 3 separate injections? if so then you can bill
96372
96372-59
96372-59
J2010
J1885
J1020
or
96372 x 3 units
J2010
J1885
J1020
You do not use the 59 on the drugs
Oh and yes the office visit with the 25 modifier.

 

[ecaissie]

Injections and modifiers

Debra:

Thanks so much - I saw it a couple of different ways in various places when I looked it up, and I wasn't sure which was right.

 

[tiger032569]

Have you gotten any results back on your 3 admin codes for the injections?
I am currently fighting that battle and for Medicare and BCBS, they will only cover 2 admins and not the third when I bill 96372, 96372-59, 96372-59 with the three J codes. Any thoughts??