Injections Under Ultrasound Guidance

bbernal

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Greater Philadelphia
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Hello,

We are a PM&R practice. Our physicians have asked us to look into whether ijections for CTS (20526), pyriformis muscle injections (20552), small joint (20600), intermediate joint (20605), major joint (20610) and Botox (64612,64613,64614) will be reimbursed under ultrasound guidance. We are located outside Philadelphia - HSG is our J12.

Questions 1) Does anyone have any experience doing these and what has been the denial/reimbursement experience? 2) Is 76942 the code to be used for the ultrasound guidance?

Am presently reviewing the medical policies of the insurers, but would appreciate any feedback. Thank you.

Barbara Coupe Bernal, MBA,CPC
 

mbort

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ENGLEWOOD/DENVER
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our docs are reimbursed for the injections without a problem, however we do not do them under ultrasonic guidance. I think as long as you have documentation to support medical necessity of both the injection AND use of ultrasonic guidance you would be fine.
 

bbernal

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Greater Philadelphia
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yes, we are reimbursed for these injections already no problem. It is the ultrasonic guidance that is new and for which I was seeking advice. thank you for the reminder that the documentation has to support the necessity of the ultrasonic guidance.
 

BCrandall

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We do Ultrasound Guidance for surgery blocks and documentation-wise you need photos, the drug used, the amount, which side, type of block and the Dr name. I use 76942 and the Anesthesia doc does the rest.
 
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