Wiki Q9966 Questions

[celcano]

Hi, All,
I could really use some assistance with this. We have a new physician who did an intra-articular hip steroid injection under fluoroscopy. He used 1ml of Omnipaque with a notation the "concentration was 240." It looks like I can bill this, but I'm not sure how. HCPCS shows this is billed per ml. I see this code has an MUE of 250 and a Medicare allowable of $0.34. So, if I bill this out per ml, that would be 1 unit which would allow $0.34. Why is there an MUE of 250 if I can only bill one ml. How should I appropriately bill this?

 

[SharonCollachi]

"Concentration was 240" means he used Omnipaque in a strength of 240mg/ml. It comes in other strengths also.

I don't see where anyone is telling you that you can ONLY bill one ml; rather, it is billed in units of one ml. If you use 20 mls, that is what you bill. Since he said he used one ml, you bill the one ml and get thirty-four cents for it.

 

[celcano]

"Concentration was 240" means he used Omnipaque in a strength of 240mg/ml. It comes in other strengths also.

I don't see where anyone is telling you that you can ONLY bill one ml; rather, it is billed in units of one ml. If you use 20 mls, that is what you bill. Since he said he used one ml, you bill the one ml and get thirty-four cents for it.

 

[celcano]

Thank you for the reply. I will show this to my physician.