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Thread: 96372 x2

  1. #11


    AAPC: Back to School
    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. #12


    HI ALL,

    Ca hcpcs medicine code be use with code 20610?

  3. #13


    HI ALL,

    Can hcpcs medicine code be used with code 20610?

  4. #14
    Join Date
    Apr 2007
    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
    Join Date
    Apr 2007
    Jacksonville, NC

    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. #16

    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. #17


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

  8. #18
    Join Date
    Apr 2007


    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. #19


    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
    Join Date
    Apr 2007


    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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