Our Dr is billing for injecting Prolia using 96372 or 99211 with the J0897 and $0 charge because patient brings meds with her. Medicare denies bc there is no charge for drug. What is the correct way to bill for the actual injection provided in the office?
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Wiki Injections
- Thread starter cpatty476
- Start date
V O
New
Hello,
For injections, I normally bill with .01 as an indication that the patient brought their own meds.Normally this particular line item gets denied which is fine, at least the claim get processed.Claims cannot be processed without a charge amount.
Also, if a patient only comes into the office for an injection, it does not warrant code 99211 unless the patient is having a low level visit included (vitals, blood pressure etc).If not so, 99211 should not be billed.The only codes that should be billed is the injection and the administration that goes along with it.
Hope this helps
For injections, I normally bill with .01 as an indication that the patient brought their own meds.Normally this particular line item gets denied which is fine, at least the claim get processed.Claims cannot be processed without a charge amount.
Also, if a patient only comes into the office for an injection, it does not warrant code 99211 unless the patient is having a low level visit included (vitals, blood pressure etc).If not so, 99211 should not be billed.The only codes that should be billed is the injection and the administration that goes along with it.
Hope this helps
mitchellde
True Blue
You cannot charge a 99211 even if vital are performed since the vitals are an integral part of the injection. These types of injections are typically planned in advance, there is no level of visit that can be billed with a planned injection. Yes you can bill the J code with a .01 charge.