-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki what cpt code do you use for the administration for syangis shot (not billing for the synagis medicine) --96372 is being denied by ins
- Thread starter evinson
- Start date
trarut
True Blue
Did you check the payer's medical policy and/or reimbursement policy for the medication for specific coding guidance? What is the specific denial reason? According to the Coding Resource on the drug website, 90378 and 96372 are listed as covered administration codes. I wouldn't use 90378 since it appears to be specifically for an immunoglobulin and this is a MAB but the payer may want it that way.
SharonCollachi
Guest
If you're billing an injection with no medication indicated (even at a zero dollar or one cent charge), that may be the reason for the denial. If you are indicating the medication, is the child under 24 months old? Also, the manufacturer advises to use 90378 or 96372 - it may be payer-specific. And lastly, is the diagnosis correct?