Wiki prophylactic inj

[00048906]

Hi- Our doctors routinely give male patients an injection of garamycin prior to prostate biopsy to prevent infection. I have been billing 96372-XS modifier to break the bundle. My thoughts were that this was not an anesthetic and should be payable. What are everyone else's thoughts on this?

 

[daniel]

The Correct Coding Initiative bundles 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) into 55700. Although the bundle has a modifier indicator of "1,"meaning this edit can be broken with a modifier, in this clinical scenario you should not report 96372 with the biopsy.