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Neurology & Pain Management Coding Alert

Reader Question:

Injection Bundled into E/M Visit

Published on Tue May 01, 2001

Question: I spend a lot of time appealing denials for payment of 90782 when billed with an office visit the same day. The visit gets paid, but the 90782 is denied as inclusive or unbundling. Can I get paid for this combination?

Oregon Subscriber

Answer: If you do an office visit (99201-99215) and an injection, you cannot bill 90782 (therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) because it is bundled into the E/M codes. To get reimbursed you need to bill the office visit code plus the HCPCS J code for the injected drug. This will allow you to get paid for both.
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