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96372 x2

  1. Smile
    Medical Coding Books
    so i will use the administrative code twice and amend modifier 59 on the second code. if this is correct, than you because you just made my day.
    Last edited by jesusislord; 03-20-2012 at 12:51 PM. Reason: speling error

  2. Default
    HI ALL,

    Ca hcpcs medicine code be use with code 20610?

  3. Default
    HI ALL,

    Can hcpcs medicine code be used with code 20610?

  4. #14
    Everett, WA
    Kristie, the payer discretion rules can drive one batty. It's a good idea to keep a notebook of each payer's preference as some do accept (want) multiple units such as 96372(2) but I've found the best way is to utilize the 96372, 96372-59 after receiving this advice from Deborah who already has chimed in.. Yes, you may get some denials for "duplicates" (!!!), but that easily rectifiable. I usually write a note in box 19, so when calling on the "dupes", I can point to that and they'll send back for reprocessing. Yes, it's a pain, but part of the business. The art of properly applying modifiers should be a separate and comprehensive component of learning medical billing and coding IMO!!
    ---Suzanne E. Byrum CPC

  5. #15
    Smile Internal Medicine Coding, CPC
    I was researching myself as I just got denied from Tricare becauase I billed 2 admin codes on the same day. Even though I used 59 modifier on one of them... I have finally got hold of a rep who said that Tricare pays up to 3 drug admin codes on a same day if modifier 59's are used. He just sent it back for reprossesing over the phone.

    Just to give you an idea... This is what I billed and I got paid for all line items:

    E/M 99213-25
    Admin 96372-59
    Drug J0696
    Admin 96372
    Drug J2930

    I hope this was helpful.

  6. Default Does 2 units of J1885 = 2 units of 96372?
    The note says "Toradol 30mg IM given". J1885 if for 15mg so I am billing 2 units. Does the 96372 also get 2 units?

    Thank you in advance for your help.

  7. Default
    The 2 units go on the drug charge. If only one injection given, then you would only bill one injection.

  8. #18
    Does it make a difference if two different drugs are injected at the same site? For example, if there were two drugs shot into the right glute, would I still bill 96372 and 96372-59, or just 96372 once?

  9. Default
    You would bill for how many injections were administered. If meds were mixed into one injection, only one injection would be billed in addition to your J-code for each drug.

  10. #20
    So if the provider doesn't document that the drugs are mixed, do we assume that they aren't and bill multiple admins?

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