Wiki B12 Injections - code for the medication

[dballard2004]

At my sites we administer B12 injections and often times patients will purchase their own B12 and bring it into the clinic and all we do is administer it. In these scenarios, we only code 96372 for the injection administration. We do not report the HCPCS J code for the medication since we did not supply it. We are receiving denials from some of our payers for the injection administration. They won't reimburse for code 96372 when it is reported by itself without the J code for the medication.

Are others encountering this problem? If so, how are you handling this? Is there a more specific way we should report these types of encounters (report the J code with $0 perhaps), or is there a modifier we should be using?

Open to all suggestions. Thanks.

 

[nutter98]

You may want to try putting the NDC # into the remarks field. I know I have one insurance that even with the J code will not pay without the NDC #.

 

[dballard2004]

Thanks so much!