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Wiki epidural steroid injections with fluoroscopy

JEWING

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FT OGLETHORPE, GA
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Can Omnipaque Q9967 be bill with 62323? Has anyone had problems with payers bundling?Procedure is being done in an office setting.


Thanks ,
Julie E
 
WE found billing information from GE healthcare.. Even if it is not payable, it should still be reported, I believe. I read that for the surgery center. As far as if done in physician offices, remember omnipaque comes in single use vials, so each procedure should have both an injected amount usually between 1 and 4 mL (1- 4 billing units) and then you need to also code the discard using -QW. The total units need to match whatever is associated with the NDC attached to your Q code. (Each NDC number codes the size and parameters of the stock bottle, so I'm sure it would raise a red flag if you discard 24 units if using the NDC off a 10 mL bottle.)

I've done a lot of research on both Epidurals (I did a 20 encounter audit in my organization and a 12 patient intital audit). This included whether or not Omnipaque should be billed - I don't have the resources at my fingertips, but my guidance is to bill for it.

Our doctors argued that "epidurogram" is included in epidural - but that's just the diagnostic imaging procedure, not the Omnipaque supply code.

We also noted that the larger bottle (in plastic) is cheaper than the smaller vial (glass) for some reason. I don't know how that would work with Medicare - if you're allowed to spend less money for the 25 unit bottle when a smaller bottle is available albeit more overhead.

I hope that helps. Feel free to reach out.
 
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