Wiki Billing for Botox in ASC

[gracec]

Hi all,

So our provider did an injection for migraines and we're getting an EOB back from the insurance company (Tricare) stating that we have a HCPCS code missing on our bill.

For the facility charges, we usually bill 64615 by itself and for the Physician's bill, we add the injection (64615) along with the drug for Botox (J0585).

As a facility, do we have the right to bill for the drug? Or should that only be on the provider's end. Please help with some clarification


Thanks!

 

[KMCFADYEN]

The physician can only bill for the drug if he does the procedure in his office. If he does the procedure in the facility, the facility bills for the drug. And of course with Botox (J0585), you bill for the drug used and for the drug wasted (adding JW modifier.