Wiki Billing for Gentamicin in the office

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almag69

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Some help please. Our physicians do Prostate Biopsies in the office and used to have the patients pick up the antibiotic Levaquin to take one day prior the day of and the day after their procedure.

My understanding from one of my docs is that there is now a resistance to this medication and our physicians are now giving the patients an injection in the office of Gentamicin 4ml prior to their procedure. They want to know if we can bill separately for this. Has anyone every billed for this medication and been reimbursed separately for it? And if so, how was it billed. Any help would be appreciated, thank you. :confused:
 
I've billed and been reimbursed for this without issue more times than I can count. The practice I worked for stopped giving Levaquin quite a while ago and went to the gentamicin injection.

Along with the billing for the biopsy, you should also bill 96372 for the injection along with J1580 for the Gentamicin. The Gent is billed in 80mg units, so bill the appropriate number of units according to how much is injected.
 
Ok thank you so for this particular patient if we inject 4ml, based on the vials we have 80mg is a 2ml vial, then we are using 160 mg. I would actually bill 160 units? I show the medicare payable amount to be $1.46 so our charge would be $233.60 for this injection? Is that correct how I am looking this.
 
2 units is correct, not 160 units. As Jane pointed out, each unit is for an 80mg injection. You'll get reimbursed a whopping 2.92 for the drug, plus the small payment you get for the injection code. In the end it's not really about the reimbursement, but patient safety and quality of care. You should still get enough back to cover your costs though.
 
denial of 96372 for NCCI for Gent injection

Hello, Is anyone else getting denials for 96372 (admin code) when billed with the procedure and the gentamicin?
I am receiving denials for the admin only when billing:

52310
96372
J1580

and similar code combinations are the same. I have successfully used XS in the past but I am finding more instances of denials based on the admin code being bundled with the procedure code.
Thanks,
Jennifer
 
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