Forum - Questions & Answers

May 15th, 2012 - sreshta 45 

96372 billing for medicare

Hi,
Can we bill 96372 with KX modifier for the following scenario?
A medicare patient came to the office with diagnosis bronchitis, diabetes,hyperlipidemia,polyarthropathy. He was seen in office and was given dexamethasone and rocephin injections. He paid for both the injections at the time of visit itself. Because he paid for both the injections can i bill only admin (96372) with KX modifier to medicare. Is the KX modifier applicable in this scenario?
Can i bill only 96372-kx to medicare or should i bill both the injections also with a zero dollar charge? I am a little bit confused whether to use KX modifier or not.
One of my colleague tried billing only 96372-kx to medicare and he got paid.
Any suggestions would be greatly appreciated

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May 16th, 2012 - sreshta 45 

re: 96372 billing for medicare

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May 16th, 2012 - rphelps 615  1 

re: 96372 billing for medicare

I add a 96372 to Medicare for established patients but no modifier.

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May 16th, 2012 - Shannan 28 

re: 96372 billing for medicare

I bill an office visit with a 96372 and use the 25 modifier for the injection fee.

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May 16th, 2012 - rphelps 615  1 

re: 96372 billing for medicare

25 modifier goes on the office visit.

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