Orthopedic Coding Alert

Question: Our physician injected marcaine into a patient's knee, but I cannot find a code for marcaine or lidocaine in HCPCS. Which code should I report for these drugs? Our biller suggested J2001, but I don't think that's correct.


Alabama Subscriber

Answer: The use of a -caine- such as marcaine or lidocaine with a joint injection is for pain control, and you should not separately report the drug itself. You should simply report the injection (such as 20610, Arthrocentesis, aspiration and/or injection; major joint or bursa [e.g., shoulder, hip, knee joint, subacromial bursa]) and any other medication that the surgeon injects, such as cortisone.

In 2004, NCCI version 10.2 first bundled J2001 (Injection, lidocaine HCl for intravenous infusion, 10 mg) into hundreds of codes, including trigger point injections, spine injections, bursa injections and scores of other codes.

If you read J2001's descriptor, you-ll see that it indicates 10 mg of the drug, which is more than orthopedists inject into patients- joints, and that it applies to intravenous infusion, which is not what your physician did.

In addition, most payers publish policies indicating that you should only report J2001 for treating cardiac arrhythmias and emergencies.

Reader Questions were reviewed by Heidi Stout, CPC, CCS-P; and Bill Mallon, MD.