Wiki injection series

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JLM929

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Correct me if i am wrong. If a patient sees a provider say on 3/19/13 and in the office notes they discussed a serious of injection with euflexxa and the insurance requires authorization. When the patient comes in for the first injection an office visit should't be billed. Correct? The patient is aware they are getting an injection that day.
 
In the office I work for if the patient comes in for an office visit and decided to start the series of injections that day while there we bill and office visit with a modifier atttached as long as the first injection was given. If the patient leaves and comes back on a different day because they had to wait for preauthorization or had to wait for a specialty pharmacy to deliver the medication then we only bill for the injection and no office visit.

Hope this helps!!

Michelle
 
That's correct, as long as the visit is just for the injection you would only bill the injection code, the history and physical would be included. HOWEVER, if they come in for the planned injection but before the procedure state that they have a separate unrelated problem and the provider does an E/M for that unrelated problem, then you could charge an OV with modifier 25. Just be sure your level is only based on the documentation related to that other problem. Just think that's important to know so you dont miss out on revenue. Hope I could help. :)
 
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