Wiki Prolia

[slc112071]

I have a question for all of you. At one time, we could bill 96401 for the administration of Prolia done on the office. Medicare then came in and said no, to use 96372. I have heard that they have now overturned that and are allowing the 96401 to use with J0897. Does anyone else have any information on that?

 

[amcgirls]

Yes I have heard the same thing. We have been getting paid for 96401.

 

[csperoni]

I am not aware of any reversal of Medicare's guidance to use 96372, not 96401 for Prolia administration. We currently bill 96401 unless Medicare or other payor guidance to use 96372.

https://medicare.fcso.com/billing_news/0496240.asp

If anyone has a reference from Medicare reversing the advice to use 96372, PLEASE share!!