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Thread: 99214 with 96372

  1. #1

    Question 99214 with 96372

    Good day,

    Can you bill an E & M code with CPT code 96372?

  2. #2
    Join Date
    Apr 2007
    Location
    Virginia
    Posts
    197

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    Yes, as long as your documentation supports it. Also, don't forget to append modifier 25 to the E/M code.

    I hope this helps.
    Teresa Collins, CPC

  3. #3

    Default

    Teresa, this has been a bit of a grey area in our office also. It is said that unless you have a separate Dx than the reason for the E/M visit, you cannot bill the admin, however I have seen a directive that states you do not need two Dx codes. If the shot (steroid/antibiotic) is for the chief complaint, and there is only one Dx, does the admin of the shot still get paid?

  4. #4
    Join Date
    Apr 2007
    Location
    Wausau, WI
    Posts
    56

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    I agree with Teresa. We bill E/M with -25 along with injections, as long as the documentation supports the physician services. If the patient came in just for the injection, such as allergy shots, and did not see the physician, then we do not bill the E/M.

  5. #5
    Join Date
    Apr 2007
    Location
    Virginia
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    197

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    Quote Originally Posted by sryen1959 View Post
    Teresa, this has been a bit of a grey area in our office also. It is said that unless you have a separate Dx than the reason for the E/M visit, you cannot bill the admin, however I have seen a directive that states you do not need two Dx codes. If the shot (steroid/antibiotic) is for the chief complaint, and there is only one Dx, does the admin of the shot still get paid?
    Yes, it does as long as the documentation supports the E/M and admin. It does not require separate ICD-9 codes. You should still append modifier 25 because the work is being done for the E/M service. As Emmy1260 stated, if the patient comes in for injections alone and no E/M visit, then just bill the admin and appropriate injection codes.

    I hope this helps.
    Teresa Collins, CPC

  6. #6

    Default

    Thank you so much for the clarification

  7. #7

    Default emERGENCY ROOM

    a 2 YEAR OLD PATIENT WAS BROUGHT TO THE er AFTER SWALLOWING A PENNY. aN EMERGENCY egd WAS PERFORMAED TO REMOVE THE PENNY FROM THE STOMACH WITH SUCESS. wHAT IS THE DIAGNOSIS, HCPCS AND CPT CODE?

  8. #8

    Default

    Quote Originally Posted by kemi View Post
    a 2 YEAR OLD PATIENT WAS BROUGHT TO THE er AFTER SWALLOWING A PENNY. aN EMERGENCY egd WAS PERFORMAED TO REMOVE THE PENNY FROM THE STOMACH WITH SUCESS. wHAT IS THE DIAGNOSIS, HCPCS AND CPT CODE?
    a 2 YEAR OLD PATIENT WAS BROUGHT TO THE er AFTER SWALLOWING A PENNY. aN EMERGENCY egd WAS PERFORMAED TO REMOVE THE PENNY FROM THE STOMACH WITH SUCESS. wHAT IS THE DIAGNOSIS, HCPCS AND CPT CODE?

  9. #9
    Join Date
    Apr 2007
    Posts
    45

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    What documentation is needed to bill an admin? I was under the impression that we needed the site, side, and type (IM). I am being told at work that all we need is the type of injection. Which is true in this case?

  10. #10
    Join Date
    Apr 2007
    Location
    Baton Rouge
    Posts
    1,085

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    Quote Originally Posted by bforr View Post
    What documentation is needed to bill an admin? I was under the impression that we needed the site, side, and type (IM). I am being told at work that all we need is the type of injection. Which is true in this case?

    This is what I've given my docs for all injection documentation, based on several articles I've read regarding injection documentation requirements:

    "Because injections are considered surgical procedures, they require a procedure note. The procedure note should include a signed or verbal consent, documentation of the anatomic location, preparation of the site, local anesthetic administration, name and dosage of drug administered, and patient reaction. Documentation should also include all postoperative instructions related to the minor surgical procedure. Documentation of lot # is not required, but recommended for liability purposes."
    Meagan Strauss, CPC, CEMC
    Coding Coordinator
    The NeuroMedical Center
    Baton Rouge, LA

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