Compiling Your Medical Billing for Specific Injections

B-12 injections are a very common procedure. If you’re only receiving partial payments or experiencing rejections of your claims, you may need to tighten up your handling of these claims as the codes and procedures for filing criteria have undergone changes in the past year. To eliminate potential medical billing problems, there are five steps to follow to ensure smooth B-12 reimbursement for your claim.

The first medical billing step is to replace the injection administration codes for the B-12. These codes include the current procedural terminology codes 90782, 90788, and G0351. These medical billing codes were deleted from the 2006 CPT list and should no longer be used. The new policy is to use one CPT for the injection: 90772 (Therapeutic, prophylactic or diagnostic injection; subcutaneous or intramuscularly).

The second step when doing medical billing for B-12 is to make sure a family physician is present during the entire administration. The medical billing CPT 90772 clearly requires direct physician supervision.

Third, it is very important to check on the insurance company’s incident-to policies. The medical billing current procedural terminology code 99211 is usually allowed without direct physician supervision, but the Centers for Medicare and Medicaid Services requires the service to be incident-to.

The fourth medical billing step is important. Since direct supervision is required for the CPT 90772, make sure you make it perfectly clear that there was a physician present. One tip is to create a stamp that clearly states “Physician supervision”, and attach this to your medical billing claims. This way, your medical billing will not be denied for such reasons.

The fifth, and final step to ensure B-12 medical billing reimbursement is to forget CMS issued G codes. The Centers for Medicare and Medicaid Services needed prescription drug codes in 2005, however, there were no CPT codes available at that time. For this reason, G codes were introduced for medical billing purposes. Once the newer CPT codes were introduced -the G codes were no longer valid.

View all Articles by: Melissa Clark, CCS-P