Billing > Billing

j codes without professional component

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wvspinner:
In our hospital, I was told today that I could not bill for a j code injectable without also billing for the professional component.  I already bill for the technical component, but the physician injecting is contracted from another group that bills the professional side.  Is this correct and if so, what are my options?

Michele:
I don't want to go against what the hospital is telling you, but based on what you have described it sounds like the physician should be billing for the professional administration of the injection.  Unless a staff member employed by the hospital is performing the injection based on the physician's orders, the physician should bill the administration.

Michele

wvspinner:
The question is who bills for the actual drug?  What I'm being told is that this particular drug - J0585 - must be attached to the professional component as it can only be injected by a physician.  Therefore, I can't bill for the drug when I'm only billing technical. 

Michele:
If the hospital supplies the drug then the hospital should be billing for the drug.  I haven't heard that you cannot bill for the drug when you are not billing the professional administration.  I'm hoping someone else on the forum may have had some experience in this.

Michele

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