Wiki Office Visits with Admin of Inj

[bdennis]

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.

 

[Teresa Collins]

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]

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]

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]

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]

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?