Results 1 to 6 of 6

Brown Bagged Drugs

  1. #1
    Default Brown Bagged Drugs
    Medical Coding Books
    Could someone please tell me the appropriate way to bill Medicare for a drug that has been brought in by the patient. My provider has only been billing the administration code 96401 and not the drug because the patient brought it in and now Medicare is requesting the $$ back for these dates of services. Please help. Thank You

  2. #2
    Location
    Fayetteville, NC
    Posts
    300
    Default
    What type of specialty is your office? Because that is a chemotherapy code.
    What type of medicine is it that the patient is bringing?
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  3. #3
    Default
    Allergy & Asthma
    The drug is Xolair
    Thanks for your help

  4. #4
    Location
    Fayetteville, NC
    Posts
    300
    Default
    I have seen where others in the forum have said to use 90772 as the injection code for this drug but there are others who have found documentation supporting the use of
    96401 because Xolair is a monoclonal antibody and the code 96401 applies to monoclonal antibodies as well. To me it is quite confusing. I'll stick to my surgeries

    Here is the discussion I am refering to:
    http://www.aapc.com/memberarea/forum...hp?t-9908.html

    Maybe that will help.
    You could appeal and send the office notes which may support your use of 96401 and see if they will reverse their decision........
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  5. #5
    Default
    We usally bill 96372 for administration of an IM drug when someone brings in their own meds, like B12 or Humira.

  6. #6
    Location
    Columbia, MO
    Posts
    12,836
    Default
    Quote Originally Posted by Grintwig View Post
    I have seen where others in the forum have said to use 90772 as the injection code for this drug but there are others who have found documentation supporting the use of
    96401 because Xolair is a monoclonal antibody and the code 96401 applies to monoclonal antibodies as well. To me it is quite confusing. I'll stick to my surgeries

    Here is the discussion I am refering to:
    http://www.aapc.com/memberarea/forum...hp?t-9908.html

    Maybe that will help.
    You could appeal and send the office notes which may support your use of 96401 and see if they will reverse their decision........
    90772 is a code that has been deleted a few years ago. I might go with 96372 or an allergy admin code. What dx code are you using.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Faye Brown book
    By niurkasilva@yahoo.com in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-26-2013, 10:07 AM
  2. A9150 Non Prescription Drugs vs J3490 Unclassified Drugs
    By saagar in forum Internal Medicine
    Replies: 0
    Last Post: 03-08-2009, 06:46 PM
  3. High Risk Drugs/Controlled Drugs
    By mjcstone in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-04-2008, 01:50 PM
  4. Faye Brown
    By Michele Wallace in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 03-25-2008, 11:53 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.