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Thread: Billing for Provenge

  1. #1

    Default Billing for Provenge

    AAPC: Back to School
    We are getting edits on our administration codes when billing for Provenge. They are asking for a modifier for both codes... 96365 and 96375. Are any of you getting this? If so what modifier are you using for these codes?

  2. #2


    Are those the only CPT codes on the claim?

  3. #3


    We are using infusion code 96413 for the Provenge. May want to veryify with your drug rep about the guidelines for your state or check directly with Dendreon at 877-336-3736.

  4. #4
    Join Date
    Apr 2007
    Grand Rapids, MI


    We are also billing Provenge as 96413.
    Ann Campbell, CPC, CEMC
    Cancer & Hematology Centers of Western Michigan

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