J3301 Kenalog Denied
They are covered based on the diagnosis, the number of times injected, and how far apart they are injected. Remember: You cannot charge an office level to administer an injection, such as 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.
Also, if the op report says “10cc of Lidocaine was injected into scar along with 40mg Kenalog,” and you bill for Kenalog (J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg) with CPT® 96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular, you cannot bill for the lidocaine. It was given for comfort and not billable. You can only bill for the Kenalog and the administration. The lidocaine is an integral component of the administration of the Kenalog and is not additionally reimbursable.