Wiki Billing B12 injection with 96372 to Medicare

[shavird@onyxsc.org]

We have recently received a denial from Medicare when billing 96372 with J3420 (Vitamin B12 injection). This was done by a PA with a medical doctor present. Medicare paid the J3420 but not 96372. The denial reason is 236: "This procedure or procedure/modifier combination is not compatible with another procedure/modifier combination provided on the same day according to the National Correct Coding Initiative....."

Any suggestions on what we need to do to correct would be greatly appreciated! Thanks

 

[shanamarie]

We have recently received a denial from Medicare when billing 96372 with J3420 (Vitamin B12 injection). This was done by a PA with a medical doctor present. Medicare paid the J3420 but not 96372. The denial reason is 236: "This procedure or procedure/modifier combination is not compatible with another procedure/modifier combination provided on the same day according to the National Correct Coding Initiative....."

Any suggestions on what we need to do to correct would be greatly appreciated! Thanks

Was anything else billed on this date of service? Office visit or other procedures?

 

[shavird@onyxsc.org]

yes... just realized that our automated system also dropped an allergy shot claim on the same day and it paid so I'm putting a 59 modifier on 96372 and setting back to file, this should do it. Thanks for your response, should have picked up on that previously.