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Thread: Prolia--mixed information--need clarification

  1. #1

    Default Prolia--mixed information--need clarification

    AAPC: Back to School

    We are an GYN-OB office. We are currently billing J3490 with 96372 with a invoice charge of $825.00.

    In speaking with our Prolia Rep. and they stated that we should be using J3590 with 96401 and we can increase the invoice charge by double.

    1.Our office is paying $825.00 per Prolia. Are we allowed to bill more than what we paying for the Prolia???

    2. Sould we be using the J3590 with 96401 codes???

    Any feed back would be great!!!


  2. #2
    Join Date
    Apr 2007


    In my office we code J3590 for the Prolia and 96372 for the injection part.
    I have no problems with receiving payment.
    You might have to put the NDC # in box 19 for some insurance.
    Our offices bills over 2000 for the medicine,
    I do suggest to increase your charge,some insurace have come back with payments of 1800.
    Good Luck!

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