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How do I bill ins for prepaid drug for injections?

  1. #1
    Greater Orlando Chapter
    Smile How do I bill ins for prepaid drug for injections?
    Medical Coding Books
    Our office has a scenario where our patients insurance wants the injectable drug Xolair billed with the administration code. but the patient prepaid the drug because their insurance would not cover it. Now the insurance said they won't pay the administration code because we are not billing it with the drug code. We billed the administration code by itself because the patient prepaid the drug so we didn't want to double bill. But it seems that they cannot be billed seperately of each other. The insurance wants the adjunct code which is the drug code j2357 code for the Xolair, as well as the admin code.
    Does the bill need to go to the insurance for the drug even though it was prepaid, and then we would reemburse the patient?
    Please email me at Thanks so much for your help
    Last edited by wjensen; 07-05-2011 at 03:45 PM. Reason: Needed to correct the injection code J2357.

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