Wiki 96401 vs 96372

[Metroderm]

I have different opinion between these two codes with my provider.
Patients for Humira, Dupixent and Stelara come to the office for the injection instead of doing themselves.
Our doctor injects for them and bill 96401.
I'm insisting with 96372 because the intensity of the injection is not high enough to bill 96401.
Does anyone in Dermatology bill 96401 for biologic medication injections?

 

[CatchTheWind]

96401 is for chemotherapy injections. Humira, Dupixent and Stelara are not chemotherapy, so you have to use 96372.

 

[Metroderm]

Thank you. I'll talk to provider again.

 

[amcook31]

You actually can bill 96401 for Dupixent because it is a biological agent. CPT 96401 is used for chemotherapy and other highly complex drugs and biologic agents. Not all payers will accept 96401, like Medicare so you have to be aware of that.