Pain Management Coding Alert
Injection Site Will Determine Neuroma Treatment Code
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Question: Our physician administered a local injection of Ketamine (25 mg) to the patient’s right chest wall due to pain from a neuroma pressing against the chest wall. What are the correct procedure and J codes for this?
North Carolina Subscriber
Answer: You can report 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) if your physician administered the injection subcutaneously or intramuscularly. If he injected the drug on or around the nerve or neuroma, you could choose between 64420 (Injection, anesthetic agent; intercostal nerve, single) or 64421 (…intercostal nerves, multiple, regional block) instead.
For 25 mg of Ketamine, submit HCPCS code J3490 (Unclassified drugs).
Your situation is a bit unusual because physicians don’t normally use Ketamine for therapeutic injections. Ketamine is a short acting anesthetic in some cases used for sedation or infused as treatment for CRPS (complex regional pain syndrome). However, you should always code based on your provider’s documentation even if he or she uses a different medication than you expect.
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