Office Visits with Admin of Inj

bdennis

New
Messages
6
Best answers
0
I'm interested to see if offices are billing office visits with administration of an injection charge. Can they be billed together and are insurances covering both? We currently are not billing the administration of an injection.
 
Messages
214
Location
Virginia
Best answers
0
We bill an E/M visit using modifer 25 and a different ICD-9 code (with supporting documentation) in addition to the administration code.

Hope this helps!
Teresa Collins, CPC
 

Lorisvg

Networker
Messages
91
Best answers
0
You should be charging the admin fee with a 25 modifier on the E/M. We also try to use a dx code than the E/M when possible
 

rthames052006

True Blue
Local Chapter Officer
Messages
1,905
Location
York, Pa
Best answers
0
I want to make sure I'm understanding this correctly, your billing an office visit ( pt being seen by physician or NPP) and they are also having an injection or are you billing an office visit and the admin just for an injection??

Just want to make sure I completely understand the question before I answer.

Roxanne Thames, CPC


I'm interested to see if offices are billing office visits with administration of an injection charge. Can they be billed together and are insurances covering both? We currently are not billing the administration of an injection.
 

bdennis

New
Messages
6
Best answers
0
Patient comes into the office and the provider determines the patient needs an injection. Is an office visit, administration of an injection and the J code injection billed, or is the administration of an injection bundled into the office visit?
 

rthames052006

True Blue
Local Chapter Officer
Messages
1,905
Location
York, Pa
Best answers
0
Thanks for the clarification, "most" insurances will pay for all 3, and then you have some insurances that don't. One insurance I know of that actually bundles the office visit into the administration code is United healthcare!!!
They don't even pay it on appeal, we've tried thousands of times with no luck.

There might be some more insurances that won't pay for all 3. I haven't had a problem with "our" major carriers like Medicare, the Blues, Blue cross, coventry just to name a few.

Good luck,

Roxanne Thames, CPC



Patient comes into the office and the provider determines the patient needs an injection. Is an office visit, administration of an injection and the J code injection billed, or is the administration of an injection bundled into the office visit?
 
Top