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Administration Code Denying for Medicare

  1. Default Administration Code Denying for Medicare
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    Is anyone out there getting denials from Medicare when a patient comes in for an office visit and has an injection the same day. The office visit gets the modifier 25, but then Medicare is turning around and paying only for the administration (96372...) service and drug and not the office visit. Is this normal?


    Thank you for the input.

  2. Default
    I've not had any trouble with this scenario. I typically add modifier 25 to the office visit and modifier 59 for the admin of the vaccine. Hope this helps.

  3. Default
    Medical Billing
    Thanks for the help

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