Pain Management Coding Alert

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Keep Drug Amounts Correct for Accurate Coding

The provider could use several different drugs during 20526 injection.

Coders need to be on the lookout for the drug type and amount when they're coding for therapeutic carpal tunnel (CT) injections with 20526 (Injection, therapeutic [eg, local anesthetic, corticosteroid], carpal tunnel).

Explanation: Accurate coding of drug supply will garner you more pay for your 20526 encounters. "All providers should bill for the drug supply separately, paying close attention to the dosage to make sure they are coding the correct units," confirms Dreama Sloan-Kelly, MD, CCS, president of Dr. Sloan-Kelly Consulting in Shirley, Massachusetts.

According to Catherine Forman, DC, CPC, COSC, CMC, of University Orthopaedic Associates URMC in Rochester, New York, most 20526 encounters will involve one of the drug supply codes listed below. Check out this list of medications that your provider might inject during a 20526 encounter:

  • J0702, Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
  • J1020, Injection, methylprednisolone acetate, 20 mg 
  • J1030, Injection, methylprednisolone acetate, 40 mg
  • J1040, Injection, methylprednisolone acetate, 80 mg
  • J1094, Injection, dexamethasone acetate, 1 mg
  • J1100, Injection, dexamethasone sodium phosphate, 1 mg
  • J1700, Injection, hydrocortisone acetate, up to 25 mg
  • J1710, Injection, hydrocortisone sodium phosphate, up to 50 mg
  • J1720, Injection, hydrocortisone sodium succinate, up to 100 mg
  • J2920, Injection, methylprednisolone sodium succinate, up to 40 mg
  • J2930, Injection, methylprednisolone sodium succinate, up to 125 mg
  • J3301, Injection, triamcinolone acetonide, not otherwise specified, 10 mg
  • J3302, Injection, triamcinolone diacetate, per 5 mg
  • J3303, Injection, triamcinolone hexacetonide, per 5 mg