If I patient came in only for injection, lets say for testoterone shot & this was done by a nurse, what is the right way to bill this scenario? I know for a fact that when a patient only came in for injection nothing more, i can only bill for the administration (96372) & for the injection itself (J1070). But my supervisor always asked me what about the office visit code, can we bill for the ov. I always answered no, we can't bill for OV on this scenario. If I'm correct, I need person in authority & credential to give me advise & explanation so I can print it and show it to my supervisor. Thank you.
I am not sure I qualify of a person of authority but:
You cannot charge an OV for a planned injection because
* The examination for the necessity of the ijection is already done and the nurse is carying out the produre ordered.
* All activity performed by the nurse is a part of the injection and the reimbursement includes this.
* A code for the injection exisits and that is what must be billed there is no substitute.
*compare this scenario to a physician givine a knee injection 20610) pt returns for a 2nd planned injection, the physician does not get to charge an OV only the injection, so this is really no different.
Debra A. Mitchell, MSPH, CPC-H
I am with a provider based facility that is designated as a rural provider, Medicare option II. Under this we bill a split bill and as such charge the vaccine code and a facility level charge (OV). But unless you are provider based under this rural option II, you cannot charge out an ov level code.