Neurology & Pain Management Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: How is a B-12 injection coded when the patient does not see the doctor? Can I charge for an E/M visit?

Arizona Subscriber 

Answer: The appropriate code is 90782 therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) for the administration. In addition, the drug code J3420 (injection, vitamin B-12 cyanoco-balamin, up to 1,000 mcg) should be billed. No E/M code should be used if the patient only receives the injection.
 
According to the Medicare Carriers Manual, Section 15502D and 15010B, it is appropriate to bill the drug code and the E/M code when professional services are rendered on the same day as an injection. However, the administration code should not be billed.  For example, when a patient schedules an office visit to be evaluated for an illness or injury and also receives a B-12 injection, it is appropriate to bill E/M codes 99212-99215 (office or other outpatient visit) and J3420, but not 90782.
 
An E/M code should be billed only when service has been rendered and the documentation warrants it.  Local carriers will most likely have their own guidelines; check with them for specific billing rules.