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Wiki Payments on injectibles

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larcwing

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Greenville, TX
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As I am posting payments I am noticing a trend on lidocaine and marcaine not getting paid. Is there a reason for this?

Thanks

A newbie
 
Are you using any modifiers???


This is how I bill out mine:

99213-25 - 4011
20550 - 72610
J1030 - 72610

Which code are they saying is inclusive?
 
It is just the J2001 and J0670 when used in combination with another injectible. I have seen one case the only injectible used was lidocaine and it got paid.
Yes we always use the mod 25 on the OV code.
 
The code J2001 is for IV Lidocaine and you are giving an intra articular injection. You cannot bill this code for the lidocaine and there is no code for the lidocaine for the route you are using, it is a comfort measure and is not therapeutic for the patient's diagnosis which is why you cannot bill it.
 
larcwing said:
As I am posting payments I am noticing a trend on lidocaine and marcaine not getting paid. Is there a reason for this?

Thanks

A newbie
Click to expand...


A 'local' anesthetic is included/bundled into the procedures. It is considered an 'integral' part of preparing the site for the procedure.
 
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