Ortho-Clinical Diagnostics, Inc. November, 2012. CPT identifies the Rho(D) immune globulin serum with these three codes. If you choose to bill HCPCS codes J2788–J2792, you will need to code and bill for the injection of the serum with either the CPT injection code(s) 96365€–96368, 96372, 96374, or 96375 as appropriate, or with the ICD-9-CM Volume 3 procedure code 99.11 (injection of Rh immune globulin). by Lori-Lynne A, Webb, COBGC, CPC, CCS-P, CCP, CHDA. Sign in to manage your specialty medications, or transfer you prescriptions from another pharmacy. V22.1          Supervision of other normal pregnancy. How will the codes change under ICD-10-CM? http://www.rhophylac.com/common/pdf/Rhophylac-Coding-Guide.pdf. How is RhoGAM given? The NDC must follow the 5digit4digit2digit format (11-digit billing format, with no spaces, hyphens or special characters). RhoGAM and MICRhoGAM are contraindicated in Rh-positive individuals and in patients with a known history of anaphylactic or severe systemic reactions to the administration of human immune globulin products. What is RhoGAM? For either an inpatient of outpatient facility, coders would report ICD-9-CM codes V07.2 and V22.1 with HCPCS code J2790 and ICD-9-CM Volume 3 code 99.11. As with any and all services, someone in your practice or facility should preauthorize the Rho(D) injection first with the insurance carrier/third party payer. Peer review vs. risk management review: What's the difference? Karl Landsteiner and Alexander Wiener discovered Rh blood types in 1940 and since then researchers have learned a lot about the genetic complexities of Rh and blood typing in relationship to fetal and maternal well being. It’s up to the coder to determine how to code the service based upon how the third party payer will reimburse for the service. The acronym "MRP" is not a trademark of HCPro or its parent company. Fast forward and I just got the bill...$617 JUST for the rhoGam shot, which insurance is saying I have to pay in full as part of my deductible. Followed by a postpartum dose given within 72 hours of delivery. For non-prescription products, read the label or package ingredients carefully. Use the Search field to find the tool you need. Code Description Brand Name NDC Requi red NDC unit of measure Category Service Limits AC OP CAH OP P NP MW MH HS PO OPH HI ID TF DC Special Instructions It can also be a recombinant immune globulin product created through genetic manipulation of human and/or animal protein. According to the product website, "RhoGAM … Once this has been completed, the physician will then determine whether the patient should receive the Rho(D) immune globulin. The risk for this happening increases with each pregnancy. It may also be used when RhD negative people are given RhD positive blood. Headache For example, if one 1500 IU pre-filled syringe is used to care for the patient, the number of billing units in this field would be 15 (1500 IU / 100 IU). 1. CVS Specialty Pharmacy provides personalized support for patients with complex & chronic conditions. Subscribe to JustCoding News: Outpatient! I have only had one outrageous bill and that was for an ultrasound. WinRho® is recommended with each pregnancy. 6.RhoGAM (Rho immune globulin human) US prescribing information. For example, enter "guide" to view all provider guides, "claim" or "billing" to view tools related to claims or billing, or "APC" to view all ambulatory payment classification (APC) tools. You can certainly use/bill code 90384 when using the Rhophylac. Email. ICD-10-CM will provide coders with more diagnosis coding options: Note that these codes all require a seventh character to identify the fetus for which the code applies. WinRho® is given at 28 weeks and when you deliver, if your baby is Rh positive. curious if you can bill 90384 when using full-dose Rhophylac (J2791)? The NDC must be … Want to receive articles like this one in your inbox? If the NDC on the package label is less than 11 digits, a leading zero must be added to the appropriate segment to create a 5-4-2 configuration. Generalized Weakness 4. Dizziness 3. Home . Know the medical gas cylinder storage requirements, Clear up confusion surrounding observation services, CMS CoP Standards for Hospitals and Proposed Chang, The first dose of Rho(D) immune globulin is to be given at 28 weeks gestation(earlier if there’s been an invasive event), A postpartum dose given within 72 hours of delivery, 90384, Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use, 90385, Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use, 90386, Rho(D) immune globulin (RhIgIV), human, for intravenous use, V07.2, Need for prophylactic immunotherapy, V22.1, Supervision of other normal pregnancy, 656.10, Rhesus isoimmunization unspecified as to episode of care in pregnancy, 656.11, Rhesus isoimmunization affecting management of mother, delivered, 656.13, Rhesus isoimmunization affecting management of mother, antepartum condition, 90384, Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use (e.g. , ” Gorman said label or package ingredients carefully bleeding and got done... 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