Our office has a few patients that are getting a Dupixent injection in office setting. We have been billing 96372-XU then billing the Dupixent as J3490 at a cost of $.01 (patient is getting Dupixent at pharmacy). Insurance will pay sometimes then other times they deny. Does anyone else have experience with billing for Dupixent administered in office and successfully and consistently getting payment?
In speaking with the Dupixent representative she believes our issues are because the drug is designed to be self-administered at home. However, our patient is 83 years old and is unable to self-administer. Our representative advised for me to file a exceptions form to the insurance carrier. The only form I have been able to find is for gap exceptions and it doesn't seem like it really applies to our situation.
In speaking with the Dupixent representative she believes our issues are because the drug is designed to be self-administered at home. However, our patient is 83 years old and is unable to self-administer. Our representative advised for me to file a exceptions form to the insurance carrier. The only form I have been able to find is for gap exceptions and it doesn't seem like it really applies to our situation.