Forum - Questions & Answers
Filing CPT® adm code 96401 with J0885 Procrit
I have worked an Internal Medicine/Onocology/Hematolgy office and have
been filing 96401 adm code with J0885 Prcocrit for patients with anemia/
CKD. these codes are CMS approved. Now Humana has come back and
said they cannot be filed together and has started requesting a refund on
our patients who have received the Procrit. I have searched the CMS
website and the Humana website and cannot find anything, just wondering
if anyone else is having this problem with Humana or any other insurance
company.
re: Filing CPT® adm code 96401 with J0885 Procrit
Procrit is a colony stimulating factor. It is a medication for the treatment of anemia (It is not chemo). IMO, 96401 is not the appropriate admin code. We use 96372 (therapeutic injection).