Wiki Coding Injections With E/m

[LRUCPC]

Help! I need to educate a group of providers (general medicine, gynecology and neurology) on the "rules" governing billing for injections with an E/M. I am looking for documentation that details WHEN to bill the injection code and WHEN NOT to bill the injection code. For example, if a patient presents for an est visit and receives an injection for b12 deficiency using his/her OWN medication. I need a "brush up" on the guidelines governing what is inclusive of a visit and what constitutes billing the E/M with a 25...etc. Any help is greatly appreciated!

 

[jmarjenhoff]

response

As long as the assistant or nurse gives the injection, you can use CPT code
90772 along with the visit code. If your office provides the B12 medication,
you would also add a J HCPCS code for the medication as well. Be careful
with this one- unless there is a documented need for the B12, ie, Pernicious
Anemia, no insurance company will reimburse for the medication or injection.
-25 modifiers are not usually needed for injections given along with the office visit.
Hope this helps.
Albuquerque Coding and Billing Professor