Neurology & Pain Management Coding Alert

Question: The patient needs injections of vitamin B12 and carries her own medication to our neurologist's office. The patient is administered the injection every two weeks. In this case, can we report code 99211?

New Jersey Subscriber

Answer: You are not correct to report code 99211 (Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician ...) for the injections that the patient is receiving. The correct code that you may report is 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular).

You may or may not report J3420 (Injection, vitamin B-12 cyanocobalamin, up to 1000 mcg). You will report the J code ONLY if required by the payer as the J3420 is NOT a cost to the practice. If that is the case, then the practice can append FB (Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device [examples, but not limited to, covered under warranty, replaced due to defect, free samples]) modifier and bill with a $0.00 amount. If not required by the payer, you would not bill for the J code at all.