Wiki Therapeutic, prophylactic and diagnostic injections and infusions

[Tracey Parsons]

Looking for some input. CPT codes in the therapeutic, prophylactic and diagnostic injection and infusion section, 96365-96376, state "specify substance or drug" when coding. If the provider is not actually supplying the drug or substance, do you actually code for the J code on the claim with a zero dollar amount or 1 cent depending on your system limitation?

 

[ollielooya]

our particular software system DOES allow for the zero dollar amount when patient purchases the medication in advance. It's usually the medication for the therapeutic injections of botox , J0585. ---Suzanne

 

[Tracey Parsons]

Therapeutic, diagnostic and prophylactic injections and infusions

Thank you Suzanne. Is it your office's typical practice to bill the J code with a zero dollar amt if patient picks up the medication? Do you read the statement in CPT "specify substance or drug" to mean that regardless of whether you are billing a dollar amount for the drug or not, you must still list the J code on the claim? Thanks.

 

[coding4fun]

Our office does a great deal of injections and if the pt brings in the medication we will properly store & label the med for pt use. For billing purposes we bill the admin code which applies and bill the J code with a 0.01 for medicare and 0.00 for all other carriers. This will marry the two codes being billed out together and give the ins carriers an idea of what you are administering.

 

[Tracey Parsons]

Thank you!