# 96372 with purchased medication



## DK47 (May 9, 2016)

Has anyone had success billing 96372 (Therapeutic, prophylactic, or diagnostic injection) and the injection with a zero charge to Medicare? Are you getting paid or am I missing something in the process? 

Any and all advice is welcome!!!

Example:
96371 x 1 $27.00
J1630 x 1  $0.00


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## jschmutz (May 11, 2016)

If the provider is supplying the drug (haloperidol) why would you be zeroing out the price?



DarlaK said:


> Has anyone had success billing 96372 (Therapeutic, prophylactic, or diagnostic injection) and the injection with a zero charge to Medicare? Are you getting paid or am I missing something in the process?
> 
> Any and all advice is welcome!!!
> 
> ...



If the provider is supplying the drug (haloperidol) why would you be zeroing out the price?


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## StacyGalloway (May 13, 2016)

When someone presents to our clinic with their own medication in hand, ( Depo-provera, Testosterone) prescribed by our physicians, we only bill out for the administration and use the diagnosis for said condition medication is for.   I am not sure why one would bill out for medication at zero.  (unless for internal reporting purposes??)


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## docsbilling (May 18, 2016)

I've not done with with WPS Medicare, but I did with Medicare Plus Blue.  Just bill the 96372 with the appropriate diagnosis.  Then, in the header, I listed the medication and the mg.  We just received payment for it.  Hope this helps!


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## docsbilling (May 18, 2016)

StacyGalloway said:


> When someone presents to our clinic with their own medication in hand, ( Depo-provera, Testosterone) prescribed by our physicians, we only bill out for the administration and use the diagnosis for said condition medication is for.   I am not sure why one would bill out for medication at zero.  (unless for internal reporting purposes??)



Hap will not pay just an administration.


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## mitchellde (May 18, 2016)

docsbilling said:


> Hap will not pay just an administration.



We list the 96372 then the J code with a $.01 charge.  You can do this only if you adjust off the $.01 charge.  Some systems will not process a $0 charge line item so you are allowed to use the penny charge as long as it gets adjusted off.  You need to list the J code for the medication along with the admin code.  If the drug is not covered then the admin will also be denied.  If the drug is one that classified as a self administered drug, then the admin will be denied.


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