Ophthalmology and Optometry Coding Alert

Question: Is there a code we should bill for subcutaneous lidocaine or lidocaine with epinephrine during an office procedure? Some of our ophthalmologists are asking for a code on the superbill, while others think we should count it in the procedure code. Should we bill separately for the lidocaine injections? North Dakota Subscriber Answer: The physicians in your group who state that the lidocaine injections should be counted as part of the procedure are partially correct. Medicare specifies that local anesthetic use is "an inherent surgical procedure component, and is not billable separately." Medicare includes all "surgical anesthesia" administered by the operating surgeon as part of the surgical package and not a payable service. There are many private, non-Medicare or commercial insurance carriers, however, that will pay for anesthesia blocks but not for topical or local anesthesia. For these carriers, you can separately bill for any anesthesia blocks administered by [...]