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Family Practice Coding Alert

Reader Questions:

What You Should Bill When Patient Supplies Med

Question: A coworker thinks that when a patient brings a prescription to our office for staff to administer, the family physician shouldn't code the medication administration, because the FP did not buy the drug. If this is true, how can the practice receive payment for giving injections of patient-supplied medicine?

Arkansas Subscriber Answer: You should report medication administration, regardless of who supplies the medication. The appropriate medication administration codes, for instance 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) or G0351 (Therapeutic or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular), reimburse you for your staff's time and the supplies - such as a syringe - inherent in the procedure.
Key: The administration codes don't include the drugs. So when a patient supplies the medication, you omit the related supply code.
Example: A Medicare patient presents for a B-12 shot and brings the Sytobex. You should bill the injection administration with G0351. But you shouldn't code for the drug, as you would if your office supplies the medication.
When your office administers a B-12 shot and provides the supply, report the injection administration with G0351 and the drug as J3420 (Injection, vitamin B-12 cyanocobalamin, up to 1,000 mcg).

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