96372 for Medicare

We do not usually bill for injections but have a patient we are giving B12 injections to. He is supplying the B12 we are just administering it. I bill medicare with 96372 but it comes back stating lacking information needed for adjudication. Any suggestions on what I am doing wrong.

re: 96372 for Medicare

What diagnosis are you using? Should pay if billed to Part B.

re: 96372 for Medicare

They are possibly denying it since no corresponding drug code is on the claim. Check with Provider Services @ your Medicare MAC. Our regional MAC re-classified B12 as a self-injectable a while back and no longer pays for the administration (or the drug if supplied by the office instead of the patient).

re: 96372 for Medicare

To bill a B12 injection to Medicare 96372 and j3420 you have to have very specific dx's. If you look up the Medicare guidelines for J3420 codr, there HAS to be 2 Specific dx's which should be the first two dx on the claim. Look it up in the medicare guide lines for the dx's that are required for this shot.