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Neurology coding

  1. Question Neurology coding
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    One of our Neurologists wants to being administering the drug Gilenya for MS patients. This is given orally unlike other meds that are infused. Patients given this new drug will still need monitored in the physicians office for up to 6 hours. Does anyone who is familiar with neuro coding have any idea what would be appropiate to bill for monitoring these patients?

  2. #2
    Burlington, MA
    Unhappy monitering for Fingolimod or Gilenya
    Hello Serfort,

    I am looking for the same information as you are. Have you received any information?

    Thank you,


  3. #3
    Hi I am looking for the same information. My email is if you would like to collaborate on this information please let me know!
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  4. #4
    Sioux City, Iowa
    Default Fingolimod
    Has anyone received "anything" in regards to the monitoring of this drug?

    Thanks !
    geebee CPC,

  5. #5
    Actually just yesterday I met with one of the drug reps and was given some "advice" I am working on making contacts with some of the groups who are already prescribing this medication!
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  6. Default
    Has anyone received final word on this??

  7. Default
    I have been advised to use an OV code along with prolonged services for the number of hours the patient is bein monitored. Haven't tried it yet so not 100% sure this will work.

  8. #8
    Default No way!
    One of my offices is billing office visit codes however that is strictly what it is! Unless your physician is going to sit there with them you cannot bill prolonged services (well non face to face prolonged but those do not pay) I am billing based on counseling/coordination of care and the physician has to see the patient!
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  9. #9
    Default Gilenya Observation
    I have been researching this as well. I believe H0033 (observation oral medication administration) would be an appropriate code. I have been directed to this code when searching online and when I refer to my HCPCS index.

    Any comments/opinions?
    Molly Shukis, CPC

  10. #10
    H0033 is listed under Alcohol & Drug Abuse, I did look at this code as well; however after reviewing this codes description and discussing with my compliance manager we did not feel comfortable using this code.

    Where did you find this direction online?

    What are your thoughts?
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

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