Wiki KENALOG INJECTION ADMINISTRATION CODE

[rleif1sun]

hi need help with this scenerio:
patient with diagnosis of Sebaceous cyst has been treated with I&D abscess and kenalog injection. I billed 10060(incision and drainage) J3301(kenalog) 96372(Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular ). payer denies the 96372 incidental to 10060. is that correct or need a modifier(59) to override?

 

[CatchTheWind]

They are correct that 96372 bundles into 10060. You would not use a modifier since they are part of the same treatment; you have to write the 96372 off as included in the I&D.

But I don't think you've used the right codes in the first place: 10060 is for I&D of an abscess; for a cyst you have to use 10140. And if you injected the Kenalog into the cyst, you would use 11900, not 96372. Luckily, these do not bundle, so you can bill them together.