afelgner
New
Good afternoon, could someone please help me with this?
Our office billed CPT 20550/20551 Trigger point injection in an office setting to BCBS. It has denied for not being billed with a J Code per policy guidelines effective 5/1/19. The Dr did not use Depo Medrol or Dexa this time so there is no additional code to bill. It has been my understanding that no code exists for the neural blockade (combination of Lidocaine and Bupivaccaine) and it is bundled into the procedure any way so we are not allowed to bill. The J Code for Lidocaine is not appropriate to use as that code is for IV use only. There is a code for the Bupivaccaine but I am hesitant to unbundle this to get the claim to go through. Do they want an Unlisted Code and then a description of what the neural block consists of? Seems like in order to do that it would have to be with a $0.00 charge amount and those won't go through our clearinghouse. I hesitate to attach a price even $0.01 to something we shouldn't bill for. No one at BCBS is able to help me with this or tell me exactly what Injections (ie surgical CPT's) are relating to this policy. Has anyone else run across this when the Dr determines no other injectable besides the neural blockade should be used? The BCBS policy is titled "Injectable Substances with Related Injection Services"
Thank You
Our office billed CPT 20550/20551 Trigger point injection in an office setting to BCBS. It has denied for not being billed with a J Code per policy guidelines effective 5/1/19. The Dr did not use Depo Medrol or Dexa this time so there is no additional code to bill. It has been my understanding that no code exists for the neural blockade (combination of Lidocaine and Bupivaccaine) and it is bundled into the procedure any way so we are not allowed to bill. The J Code for Lidocaine is not appropriate to use as that code is for IV use only. There is a code for the Bupivaccaine but I am hesitant to unbundle this to get the claim to go through. Do they want an Unlisted Code and then a description of what the neural block consists of? Seems like in order to do that it would have to be with a $0.00 charge amount and those won't go through our clearinghouse. I hesitate to attach a price even $0.01 to something we shouldn't bill for. No one at BCBS is able to help me with this or tell me exactly what Injections (ie surgical CPT's) are relating to this policy. Has anyone else run across this when the Dr determines no other injectable besides the neural blockade should be used? The BCBS policy is titled "Injectable Substances with Related Injection Services"
Thank You