Separate Infusion/Injection Billing Won't Do
Published on Tue Feb 01, 2005
Beware of NCCI 'G' code bundles
Medicare created new HCPCS Level II codes for injection and IV infusion - but many pathology procedures already include the "needle" services, according to the latest NCCI edits, so you can't bill them separately. NCCI version 11.0 took effect Jan. 1. Aspirations, Transfusions Include Needle Codes NCCI 11.0 bundles three new "G" codes for injection and IV infusion. "Don't report the following codes for any service that already includes an injection or IV infusion service, says Laurie Castillo, CPC, CPC-H, CCS-P, owner of Castillo Consulting in Manassas, Va.:
G0345 - Intravenous infusion, hydration; initial, up to one hour
G0347 - Intravenous infusion, for therapeutic/diagnostic (specify substance or drug); initial, up to one hour
G0351 - Therapeutic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular. NCCI bundles the relevant G codes with the following codes for fine needle aspiration (FNA), apheresis, bone marrow transplant services, stem-cell harvesting, and certain transfusion medicines:
10021 - Fine needle aspiration; without imaging guidance
10022 - ... with imaging guidance
36511 - Therapeutic apheresis; for white blood cells
36512 - ... for red blood cells
36513 - ... for platelets
36514 - ... for plasma pheresis
36515 - ... with extracorporeal immunoadsorption and plasma reinfusion
36516 - ... with extracorporeal selective adsorption or selective filtration and plasma reinfusion
36522 - Photophoresis, extracorporeal
38205 - Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogenic
38206 - ... autologous
38230 - Bone marrow harvesting for transplantation
38240 - Bone marrow or blood-derived peripheral stem cell transplantation; allogenic
38241 - ... autologous
38242 - ... allogeneic donor lymphocyte infusions
86890 - Autologous blood or component, collection processing and storage; predeposited
86891 - ... intra- or postoperative salvage
86950 - Leukocyte transfusion. Choose 1 Bone Marrow Aspiration Code When the pathologist performs a bone marrow aspiration and bone marrow biopsy through the same incision, Medicare now instructs you to report the aspiration using new code G0364 (Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service).
NCCI 11.0 lists this code as mutually exclusive with the CPT code for bone marrow aspiration: 38220 (Bone marrow; aspiration only).
That's because the pathologist would only perform one of these procedures for the [...]
