Ob-Gyn Coding Alert

Answer: Because the patient only receives an injection, you should not report 99211 (Office or other outpatient visit for the evaluation and management of an established patient ) unless a minimal E/M service has been documented an office note containing only the drug name, the dosage and the fact that it was injected is insufficient. Instead, you should report the injection administration with 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular).

Although your question indicates that the patient supplied the drug, in many cases the physician provides the medication. In this case, you would report J1051 (Injection, medroxyprogesterone acetate, 50 mg) in addition to the injection code. You should indicate the total dosage by adjusting the quantity box on the claim form. For instance, if the ob-gyn injected 100 mg, the quantity would be 2; for a 150-mg dose, the quantity would be 3. This is a new HCPCS code for 2003. Previously, you would have reported Depo-Provera with J1050 (Injection, medroxyprogesterone acetate, 100 mg), but this code has been deleted.