Wiki billing 99211 and 96372

[MSTRICKLAND74]

I know you do not bill both codes for a single encounter. We meet the qualifications to bill either one with our injections and we typically bill the 96372. Does anyone know if you can pick which payers you bill which one to? ex medicare patient comes for B-12 injection I bill J3420 and 96372 but a BCBS patient comes for B-12 injection I bill 99211 J3421. is that ok, or should billing be uniform for all payers?

 

[mitchellde]

No you cannot chose which one as they are not interchangeable services. If the patient presents for a planned injection then you cannot use a 99211 for the injection. Many payers do cover B12 injections, so if the 96372 is denied for coverage then the injection is patient responsibility.

 

[jonest1]

Remember is not appropriate to bill differently based on what insurance the patient has.