Coding Cues: Low reimbursement for injectables

February 15, 2008

Much as I don't wish to, I may have to stop providing my patients with injections. The reimbursement doesn't cover the cost of the drug, much less the cost to administer it. Any tips on how to deal with this problem?

Much as I don't wish to, I may have to stop providing my patients with injections. The reimbursement doesn't cover the cost of the drug, much less the cost to administer it. Any tips on how to deal with this problem?

First, make certain you're reporting the correct units of service for the drugs you administer. J codes-used to identify the medicine you inject-come in units, and you may need to charge for more than one unit to fully cover an injection. For instance, one unit may equate to 10 mg, but you or your nurse administers 20 mg. In this case, you should submit two units on the claim form.

Another option is to give the patient a prescription for the injectable. He can then fill it at the pharmacy, and return to you to administer the shot. Inconvenient? Perhaps. But you'll avoid the cost of buying the drugs yourself.