You Be the Coder:
Billing for Drugs
Published on Fri Mar 01, 2002
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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our coder is billing for ProCaine, Kenalog and Lidocaine using the same HCPCS code, saying that they are all name-brand versions of the same injectable anesthetic and should therefore be coded the same as one another. What are the correct codes for these?
Florida Subscriber
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Answer: These drugs are absolutely not the same medication, and should not be coded as such. ProCaine is billed using J2690 (Injection, procainamide Hcl, up to 1g); Kenalog is billed using J3301 per every ten milligrams used (Injection, triamcinolone acetonide, per 10 mg), and Lidocaine is coded J2000 (... lidocaine HCL, 50cc).
Even if two drugs seem similar (as Lidocaine and Procaine do), it is not appropriate to assume that they are comprised of the same generic ingredients and can therefore be coded identically. Always consult your HCPCS source to determine the most accurate code to use. If HCPCS does not refer to the drug by its brand name and you are not aware of the generic name, ask the physiatrist or consult the company that sold you the drug. Many pharmaceutical companies maintain customer billing hotlines to help straighten out such matters. | |