Wiki 96372 with purchased medication

[DK47]

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

 

[jschmutz]

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

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

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

 

[StacyGalloway]

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??)

 

[docsbilling]

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!

 

[docsbilling]

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.

 

[mitchellde]

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.