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Billing North Carolina Medicaid for depo injections

  1. Default Billing North Carolina Medicaid for depo injections
    Medical Coding Books
    Help - I am using the code 96372 and it is being denied - pt brings depo - we inject - charge nothing for the J code but I do put it on the claim so the payor will know what is being injected. Use 96372 as the inj code but it is being denied....any ideas?
    Thank you!

  2. #2
    Location
    Columbia, MO
    Posts
    12,841
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    Do not bill the J code at all since the patient supplied it.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Raleigh, NC
    Posts
    20
    Default
    I work in a OB/GYN office in Raleigh. We bill the 96372 & the J code billed with a zero charge & ICD-9
    V25.09. Plus with modifier FP for family planning. Medicaid's policy states you must put modifier FP, if it is for family planning.
    Hope this helps!!

    Michelle Raymond, CPC
    Last edited by mraymond74; 07-29-2009 at 07:59 AM.

  4. Default
    I am in NY and till anout 5 months ago we used the same code for inj. BUT most of our carriers switched to "90471 Injection of med. IM or SO". I am NOT sure sure about your state though. See if you can call them again (spend another 1/2 day on the phone) (SORRY) and see if its a paybale code.

  5. #5
    Location
    Columbia, MO
    Posts
    12,841
    Default
    Quote Originally Posted by dan528i View Post
    I am in NY and till anout 5 months ago we used the same code for inj. BUT most of our carriers switched to "90471 Injection of med. IM or SO". I am NOT sure sure about your state though. See if you can call them again (spend another 1/2 day on the phone) (SORRY) and see if its a paybale code.
    90471 is for immunizations, I am having a hard time calling depo an immunization to prevent pregnancy.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Thanks to all of you!

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