Wiki 96372 x2 inj code with Amp Gen

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RMac

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We often use Ampicilin/Gentamicin during an office proceedure. Question is, we are billing and have billed, 96372 and 96372-59 to medicare for years under Palmetto. Now, with Noridian, they pay one and not the other. I've been told to use the 76 on BOTH 96372 entries and still get denials. I've called reopening line, etc and still, the best sequence i've found is doubling the injection price and using quantity 2.

thoughts Please...I have to fix 50 of them...

Thank you.
 
These are medicine codes and are to be billed on one line according to how many units/x administered given. So if you are performing two different administrations with 1 drug each, that would equal 2 units. If the drug is mixed into one syringe, this only supports one administration would be reported as 1 unit.

A modifier 76 is not correct, they are not a repeat of a previous identical procedure because you have two different drugs.

You don't need to double your fee, the computer will pay the base price x 2.
 
I didn't think the 76 was correct given they are two seperate meds., but hey, they're Medicare...

Ok, this makes much more sense to me and I will implement immediately.

Thank you!
 
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