99211 for a injection

grandmacora

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When a pt comes in just for a injection in the knee we bill 20610 and the j code. They do not examin the pt just the injection is given the Doc gives the pt the injection.We have been billing the 99211 with a 25 modifier. Do you think we should use the 99211 and the 25 or just bill the injection? The J code used is J1030 for Depo Medro. Thanks so much
 

MnTwins29

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Just the injection

Without seeing the documentation, I would suspect you should just bill for the injection, as any type of E/M services would be part of the injection (cleaning the wound, a qucik exam of the area, etc). If something else was addressed, then a separate E/M code would be warrented, but from this description, I would only code the injection and drug.
 

mitchellde

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no you cannot bill an E&M of any level when the patient is scheduled for a procedure or service. You have not met the parameters of the 25 modifier for significant and separately identifiable service. Every procedure has the assessment that is necessary to perform that service already included and you cannot bill separately for it.
 
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