Wiki Zometa Administration/Aetna

[YesicaRuedas]

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]

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.

 

[chrispamsimpson]

We bill Aetna for Zometa treatments and 96365 is the admin code we use. Not having any problems getting paid.