Neurology & Pain Management Coding Alert

If you're billing J2001 with injections, the latest NCCI will get your attention If you still report J2001 for lidocaine as an anesthetic when you perform injections, expect denials starting July 1.

Although most payers already bundled lidocaine payment into your injection fees, a new National Correct Coding Initiative (NCCI) edit confirms that you should never bill J2001 for pain management. HCPCS deleted J2000 (Injection, lidocaine HCl, 50 cc) this year and introduced J2001 (Injection, lidocaine HCl for intravenous infusion, 10 mg) in its place. Although most coders accurately took this as a sign that Medicare would no longer allow them to report lidocaine for the small amount of anesthetic that they injected for pain management, some coders simply changed their claim forms and started billing J2001 with every lidocaine injection. NCCI's version 8.1 bundled J2000 into several injection codes (such as 20526-20610), which stopped many neurology practices from billing lidocaine with trigger point injections (20552-20553). Now, NCCI 10.2, effective through Sept. 30, continues the trend of bundling J2001 into hundreds of codes, including additional trigger point injections, spine injections, bursa injections and scores of other codes.

"The injection of a 'caine' while doing a joint injection is for pain control and shouldn't be billed separately," says Denise Paige, CPC, president of the American Academy of Professional Coders'Long Beach chapter. "There are those who think that this never should have been billed separately in the first place, and I think the deletion of J2000 further backs up that theory."