Zometa Administration/Aetna

YesicaRuedas

Networker
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Hello,

I need some help in regards to Zometa and Aetna as the payor. I would like to know if anyone has had any issues in getting reimbursed for Zometa's administration. I been using 96413 w/ dx code 203.00. The insurance is telling me that its bundled with the Zometa and that I need to add a modifier 59 to the administration. I dont think this is correct.

Any input will be appreciated.

Thanks!
 

aprram77

Contributor
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10
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Although it's been couple years since I've done chemotherapy billing & coding I think I know why your having a issue. Your billing Zometa which is non-chemotherapy drug with a chemotherapy administration 96413 code. I believe you should be billing the Infusion of Zometa with CPT code 96365. I hope this helps. :)
 
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