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Primary Care Coding Alert

READER QUESTIONS :

Supervision Situation Alters Xolair Admin Coding

Published on Sat Jun 06, 2009

Question: An established 19-year-old patient with allergic asthma reports to the FP for a scheduled Xolair injection. A qualified nonphysician practitioner (NPP) injects the patient twice with 50 mg of Xolair. Can I report an injection code for this, or is it considered an E/M service since an NPP performed the injection? Georgia Subscriber Answer: Your code choice will depend on what role, if any, the FP had in the encounter. Option 1: If the FP provides direct supervision during the encounter, then you should report the following: " 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) for the first Xolair injection " 96372 for the second injection " Modifier 76 (Repeat procedure by same physician) appended to the second 96372 " 493.90 (Asthma; unspecified) linked to all the injection codes to represent the patients condition " J2357 (Injection, omalizumab, 5 mg) x 20 for [...]
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