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Wiki Help with HCPCS codes for trigger points (please!) Pain Management

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CoderinJax

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I'm reviewing a Trigger Point injection record and it states:

"5mg/ml of soluble non-particulate dexamethasone and remaining volume of .25 preservative-free Marcaine for a total volume of 5cc".

- billed J1030, 4 units

I've tried to Google this and can't figure out if, A) that is the correct HCPCS code and B) if the units are accurate.

Anyone able to offer assistance? THANKS SO MUCH!:confused:
 
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I don't believe that J1030 is the correct code since J1030 is for Methylprednisolone 40 mg inj.

You are probably looking for code J1100 - Injection, dexamethasone sodium phosphate, 1 mg. This would be billed out at one unit per mg administered. I would recommend confirming with the provider that this is the correct medication since there is a very similar medication J1094 - Injection, dexamethasone acetate, 1 mg. But the sodium phosphate is usually used for soluble dexamethasone.

Marcaine is also known as bupivacaine hydrochloride. There is a code S0020 - Injection, bupivacaine hydrochloride, 30 ml. But given the small dose that the patient received, I don't think you will be able to bill separately for the Marcaine. We do not typically bill for any of the local anesthetic medications (lidocaine, bupivacaine, etc.) since they are usually considered inclusive.

Jonique Dietzen, Project Manager, CPC
 
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