Wiki Joint injections with office visit

[vhammons]

If a patient comes in for a joint injection, can you bill both an office call and the 20610? No other condition was addressed at this visit. The NP insists she should get a level of service and injection fee. If I understand it correctly, you can't.

 

[erjones147]

Based on what you posted, you are right and your NP is wrong

 

[vhammons]

joint injection

Thank You, that's what I thought.

 

[MarcusM]

http://www.wpsmedicare.com/j5macpartb/resources/modifiers/modifier-25.shtml

Modifier 25 Fact Sheet
Definition:"Significant, separately identifiable evaluation and management (E/M) service by the same physician on the day of a procedure."
If the E&M has not gone "above and beyond" the normal pre-surgical exam then the 20610 should be the only code billed.

 

[OCD_coder]

Here is a nice article by the AAOS regarding joint injections that I find helpful with educating my physicians and NPP's.

"Taking the pain out of injection coding"

http://www.aaos.org/news/aaosnow/oct09/managing1.asp

 

[ollielooya]

No, office visit may not be charged in addition to the pre-scheduled joint injection. From a physician perspective it is understandable why they might be expecting to be paid for the "evaluation" for the procedure, but this is built into the procedure itself and add'l payment is not to be expected.