Wiki Injection anesthetic agent lumbar or sacral

[hudsondna]

We (billing company) do the billing for a pain management physician. He indicated to me that injection anesthetic agent lumbar or sacral 64475 or 64476 can only be done in and inpatient or ASC setting for Medicaid to cover this service. Is this correct or has anything changed were it can be done in the office setting.
Thanks for some help on this!!!
Anita

 

[cconroycpch]

You would have to check with the local Medicaid office. Medicaid may not reimburse enough to cover the expense of doing the procedure in the office. What state are you in?

 

[hudsondna]

We are in Texas. I have tired to call the customer service at our local Medicaid office and they have not a clue what I am talking about. I have just about read the provider manuall form cover to cover and can't find anything there. my next step is the Medicaid provider rep.

 

[tkuka]

We are having the same issue with billing GA Medicare for these procedures. We are finding that it's not a requirement to be inpatient, but that these procedures can't be billed without also billing a fluoroscopic code for the guidance of the injection. Their coverage paper takes the position that the precision required of these injections necessitates using fluoro guidance and that if you are not using guidance then you did not do this precise an injection. I came to this board hoping to find help with our sitiuation. Let me know if you find anything.

Thanks.