Wiki Help please what term to look for when coding injection/medications

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MrsB

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I am going over some practice questions and I'm trying to brush up on CPC and HCPCS. What is the procedure code and how do I go about
step by step finding the code and how do I select the medications?


"Pt is here today for a right knee corticosteroid injection."

"....using sterile technique, 1 cc of 40 mg Kenalog and 4 cc of 1% lidocaine and 4 cc of .5% Marcaine was injected in the right knee through
the anteroloateral portal without difficulty."

Thank you in advance.
 
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Can you tell us your step-by-step thought process so we can tell you if you're on the right track, or completely off-base? I would rather do that than just give you the answer straight out.
 
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Well, for the injection I go the CPT index- Injection- Knee but neither Adipose cellular Implant or Radiological is correct so I'm stumped.

For the HCPCS, I cannot locate Kenalog in the table of drugs. I chose not to use Google because I'm thinking about the exam which is not
accessible. Table of Drugs-Lidocaine takes me to J2001 but I'm not sure how to code that correctly as far the mg and cc's if there's a modifier involved. Table of Drugs- Marcaine is not found.
 
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The injection was in the joint. Try looking up the joint instead of knee. Another name for Kenalog is Triamcinolone, try that in the HCPCS book. At our practices we don't bill for the Lidocaine and Marcaine..it's just used to numb the area before the injection. Hope that helps.
 
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Thank you. Just it would be a bummer getting an answer like that wrong if I get something similar on the exam since you can't google. I can't be expected to memorize an entire dictionary of generic medications, lol.
 
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So you weren't terribly far off, I just wanted to see how you were doing.

In the index in the back, for any body part that has a joint, go to INJECTION, then JOINT. If you go to KNEE, you're not going to find it. At JOINT you will find 20600, 20604-20606, 20610, 20611.

In the front, if you go to the Surgery section, you will see INTRODUCTION OR REMOVAL 20500-20705.

Starting at 20600, you will find Arthrocentesis, aspiration, and.or injection, and that's the section you want. The codes are separated into small, intermediate, and major joints, but the definition of those terms are included in the code. You also have a code under each one for "with ultrasound guidance", and since the question didn't mention it, there is no ultrasound guidance.

The lidocaine and marcaine are bundled into the injection, so it would be incorrect to bill those.

I don't know what you're allowed to do for the test, I would hope you could write in some common brand-name drugs. Kenalog-40 is J3301. One unit is 10mg, so you would bill 4 units.
 
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There'a an index at the back of HCPCS -Appendix A - shows listings for trade names and generic names of drugs. Kenalog is listed there as triamcinolone acetonide and underneath J3301 it shows Kenalog for trade name. I have no idea why both names aren't listed in the index as that would make thing a lot easier wouldn't it? Mark common drugs in your book in the index as well as in Appendix A but if you use them often enough you'll start to memorize them.
 
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