Billing for in office ESI's etc


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Our office just opened up a flouro suite for our pain management and spine physicians to start doing their ESI's, RFA's, MBB's etc etc in office. I have never coded for anything other then the typical "62311" etc for these procedures so I am scrambling to get research done on everything that is billable. Right now we are billing for basically everything the procedure, meds (except those we know are included like "caine" drugs to medicare and contrast), supplies, pre-op testing (we are literally just billing everything initially and waiting to see what's payable and what's denied per insurance company) some docs are asking if additional needles are billable which is something I never even thought of. So now I am trying to get some advice from other coders that have in office flouro suites on what you've found you can bill for and can't just incase there's anything else I am missing.

ANY help would be greatly appreciated!! Thank you so much in advance!
We bill for all of our supplies and meds and some payers will pay on some of those and some won't. We just write off the supplies they don't pay on. A lot of payers won't reimburse you for the supplies or at least not all of the supplies. I don't believe additional needles are billable. I believe they are considered inclusive in your procedure code. Hope this helps. I am new to pain management but that is my experience thus far.

I bill for the procedure and the supplies. Some insurances pay and some deny inclusive. You will get used to who does what. Some insurances do pay for the Fluoro 77003, but most include this with the epidural.

Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management
62311 and supplies

Supplies are typically included with this procedure-contrast is included. There is also an NCCI edit on the fluoro 77003-included in the 62311- many payers follow the NCCI edits, so this is why it will not pay in many circumstances. Of course, I do have a 2016 expert book that states to charge 77003 if used - unless a formal contrast study is performed.