Anesthesia Coding Alert

Reader Question:

Numbing Before Anesthesia

Question: Our anesthesiologist uses xylocaine to numb the area before administering the drug for trigger-point injection or other procedures. Can this be billed separately?

New Jersey Subscriber  
Answer: Anesthetics like xylocaine usually are injected in the joint, trigger point or bursa to numb the pain and are considered part of the treatment injection. Heres an example of how you would bill for an arthrocentesis. Bill for the procedure with 20610* (arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) and the injected drug code J0810 (injection, cortisone, up to 50 mg), but not the anesthetic used to numb the area. You could also bill for the initial syringe and needle with A4209 (syringe with needle, sterile 5 cc or greater, each).
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