Urology Coding Alert

READER QUESTIONS:

New Injection Codes Follow Old G Code Rules

Question: Now that the temporary injection codes G0356, G0351 and G0347 have been replaced with new codes, can the new codes be billed with office visits the same way the G codes could be?


Michigan Subscriber
Answer: The same rules apply to the new injection codes that applied to the G codes. You can report a separately identifiable E/M service with the new injection codes using modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

Pitfall: The exception is 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician), which you cannot ever report with any of the injection codes because the work RVUs are similar and are already factored in to the injection code. So, if you have an E/M service, higher than a level one, that you can show is separate from the injection service, you may use modifier 25 and report both services.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All