Ob-Gyn Coding Alert

Reader Question:

Antibiotic Injection Service Is Part of Cystoscopy Code 52000

Question: We routinely see patients to give them antibiotics via injection prior to cystoscopy. We normally bill for both the cysto and the injection with 52000 and 96372-59. Are we correct in billing separately for the antibiotic injection? In addition, our latest patient for this scenario had previous knee surgery and has a proven allergy to Cipro, which we normally administer by mouth without a charge. Due to her allergy to Cipro we plan to give an injection of gentamycin instead. What are your thoughts on this?

Nevada Subscriber

Answer: Per NCCI (National Correct Coding Initiative) edits, drug administration services related to operative procedures are included in the associated procedural HCPCS or CPT®  codes. Therefore, cystoscopy 52000 (Cystourethroscopy [separate procedure]) includes the service associated with 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular). Only bill for the cystoscopy with 52000.

Silver lining: Even though you cannot bill for the injection itself, you can still report the appropriate J code (drug code) with the units of the drug administered and be paid for the drug.


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