Practice Management Alert

Question: Is there code we should be billing for administering subcutaneous lidocaine or lidocaine with epinephrine during an office procedure? Some of the physicians in our group are asking for a code on the superbill, while others think we should count it in the procedure code. Should we be separately billing for the lidocaine injections?

Pennsylvania Subscriber

Answer: The physicians in your group who state that the lidocaine injections should be counted as part of the procedure are correct. CPT specifies that local anesthetic use is "an inherent surgical procedure component, and is not billable separately."

The only code for lidocaine is J2001 (Injection, lidocaine HCl for intravenous infusion, 10 mg). In 2004, CMS deleted J2000 (Injection, lidocaine HCl, 50 cc), which many practices were using to bill for injected lidocaine. You cannot consider J2001 the same way, however, because the code descriptor specifies that the physician must administer the lidocaine via an IV infusion to use this code. In fact, the Correct Coding Initiative (CCI) bundles J2001 with many minor procedure codes to specifically prevent you from reporting it with an injection code.

-- The answers to the Reader Questions were provided and/or reviewed by Barbara J. Cobuzzi, MBA, CPC, OTO, CPC-H, CPC-P, CHCC, director of outreach programs for the American Academy of Professional Coders, the coding organization in Salt Lake City