Wiki J3301 - associated tenderness

jmjam2005

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Hello everyone- Im just wondering some input on how you would code this? My main concern is the kenalog. I currently bill at a neurology clinic and me & the other biller do not agree on how to code the J3301. Would love to hear what my fellow members think? Thank-You in advance =)

Procedures
BILATERAL GREATER AND LESSER OCCIPITAL NERVE BLOCK:
Patient presents with bi-occipital headache with associated tenderness radiating to the bifrontal regions of the head. Signs and symptoms are consistent with an occipital neuralgia.
Procedure was explained to the patient. The patient relayed understanding of the risks and benefits involved.
1.5 mL of 40 mg/1 mL of Kenalog mixed with 1.5 mL of 2% Lidocaine was injected in the following manner:
1.5 mL in the right and left greater occipital nerve region
1.5 mL in the right and left lesser occipital nerve region
Patient tolerated the procedure well. No immediate complications seen. Patient is recommended to continue with previously recommended managment. Patient presents with pain and spasms in the bilateral cervical regions, with assoiciated tenderness radiating to the lower cervical region. Patient also complains of pain and spasms in the lower lumbar regions, with associated tenderness radiating to the lower extremities.
Procedure was explained to the patient. The patient relayed understanding of the risks and benefits involved. 6 mL of 40 mg/1 mL of Kenalog mixed with 6 mL of 2% Lidocaine 20 mg/mL mixed and injected in the following muscles:
2 mL right and left supraspinatous muscle
2 mL right and left trapezius muscle
2 mL right and left cervical paraspinal muscles
2 mL right and left glutei muscles
2 mL right and left lumbar paraspinal muscles
2 mL right and left sacral paraspinal muscles
Patient tolerated the procedure well. No immediate complications seen. Patient is recommended to continue with previously recommended managment.
 
1st scenario - Bilateral Greater & Lesser Occipital nerve block - 1.5 mL of 40 mg/mL of Kenalog or a total of 60 mg was injected J3301 is based on 10 mg, so 60 mg would be billed with J3301 with 6 units of service

2nd scenario - Bilateral cervical regions - 6 mL of 40 mg/mL of Kenalog or a total of 240 mg was injected. Coding would be J3301 with 24 units of service
 
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