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visit with injection denied

  1. #1
    Location
    Melbourne, Florida
    Posts
    124
    Default visit with injection denied
    Exam Training Packages
    any suggestions on how to receive payment from Medicare when we bill for an administration of an injection (90471) , but not for the product (zoster for shingles) .. I believe the 99211 will be denied ..and we cannot bill it with a modifier 25. (the 90471 alone is denied since it is not accomanied with the zoster, since the patiend supplied it, we didn't bill for it..... once again.. any help is appreciated.
    Denise Gilrane-Pillow, CPB

  2. #2
    Location
    Johnson City
    Posts
    202
    Default
    I have a question:

    Did you have the patient purchase the drug, and bring to appointment? I was just wondering because we have been tracking our reimbursement on our injectable drugs. We lose alot of money on the drug code reimbursements. I was curious to know if this is common with other practices. Or are we missing the boat somewhere?

    Thanks
    Melissa Jewett, CPC

  3. #3
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    Will your practice management (billing) software let you put in the code for the zoster vaccine with a zero or 1 cent charge? That is what we do with state-supplied vaccines, so the insurance knows which vaccine we are injecting.

    Hope this helps!
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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