Wiki help with injection code for Cimzia

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bmaxwell3

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has anyone coded for the use of Cimzia? they use 2 injection sites. can you use cpt cpde 96372 x2 sub q theraputic injection or 96401 x2. The sales rep believes there is better reimbursement with the 96401 but I would like to know what is allowed :) Also can a level 1 office be charged with a mod 25 with this?

Help!

thanks Bridget
 
I do not have my book handy and I do not recall the descriptor for the 96401, however you may NOT bill a 99211 with the 25 modifier to give an injection.
 
Cimzia injections

thanks Debra I did not think so either since you can not do so for a synvisc injection. But I am trying to make sure we are billing the correct injection code for the cizmia since this is a new drug to our practice do you think you may have some extra information tomorrow if I check back? I Have come up with the Jcode but nothing else.

Thanks
Bridget
 
From what I am able to discern, Cimzia is not a chemotherapy agent it is for RA or Crohns disease. Therefore I would go with
96372
96372 59
And again no 99211 just the addition of the J code and you are done.
 
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