Wiki Kenalog billing

[mgarcia400]

Does anyone know the proper way to bill a Kenalog injection? We are a family practice and have a new provider that uses Kenalog. Would the procedure code be 20610 or 96372? What should the units look like on a claim?
Any insight would be helpful.

 

[SharonCollachi]

The medication does not determine the injection code; the type of injection does.

If it's a general intramuscular injection, then it's 96372. If it's into a major joint (shoulder, hip, knee, subacromial bursa), then it's 20610. Other joints are small joints (fingers, toes) - 20600 and intermediate joints (wrist, ankle, elbow, acromioclavicular - 20605). Trigger points have their own codes.

Kenalog is billed per 10mg.

Here is a major joint with 30mg Kenalog:

1 unit, 20610
3 units, J3301

 

[ivorytofu@hotmail.com]

you will need to bill the correct NDC# with the Kenalog.

 

[mgarcia400]

The medication does not determine the injection code; the type of injection does.

If it's a general intramuscular injection, then it's 96372. If it's into a major joint (shoulder, hip, knee, subacromial bursa), then it's 20610. Other joints are small joints (fingers, toes) - 20600 and intermediate joints (wrist, ankle, elbow, acromioclavicular - 20605). Trigger points have their own codes.

Kenalog is billed per 10mg.

Here is a major joint with 30mg Kenalog:

1 unit, 20610
3 units, J3301

Thank you. Very helpful!