Wiki 1 or 2 units of 96372

[slc112071]

Could someone please help me? I know that I have seen that if a patient gets two injections of a pre-filled syringe of any medication, that you only bill 1 unit for the injection code. Does anyone have a link that supports the using only 1 unit? This goes for meds like Evenity, Xolair, Cimzia, etc.

 

[thomas7331]

There's no guideline that I'm aware of that says you can only bill one unit. The facility where I worked for several years performed Xolair injections and always billed 2 units for these - I was never aware of any denials or other reimbursement issues with this. I would mention, however, that I believe Medicare reimburses a flat APC rate for this service under OPPS, so for outpatient hospital billing, there won't be any additional payment for additional units.