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  1. #1
    Default Help
    Medical Coding Books
    a rep is trying to sell my docs a "kit" that includes : gloves, lidocaine, bandaid, depomedrol

    they want us to charge unlisted "drug" code for the kit

    I told them NOPE, you would not use unlisted code when there is a more specific code to use (depomedrol) I also told them you cannot bill for gloves, lidocaine ect...they are included in the injection, even if you put it all in a pretty box.


    Am I wrong ? Anyone heard of this one yet?

  2. #2
    Default
    I believe you are 100% correct in this. Sounds like fraudulent billing information is being given from this "rep". I'd report him/her for sure! Good luck.

  3. #3
    Location
    Hartford, CT
    Posts
    723
    Default
    I haven't heard of this yet, but it doesn't surprise me. And...you are absolutely correct that these are included, first, CPT 2014, Professional Edition, page 62 says "Supplies and materials (eg sterile trays/drugs), over and above those usually included with the procedure(s) rendered are reported separately...." Since nothing listed in the "kit" is over and above what is usually included he can't bill.
    Second, the NCCI Policy Manual, Chapter L, General Correct Coding Policies on page I-10 lists what is included in a "surgical package" and supplies is on the list.

    So maybe you can show your doc these references and hopefully save him some money (not paying for these Kits) and keep him compliant at the same time.
    Doreen Clark, CPC, CPMA
    Medical Auditing Specialist
    Integrated Physicians Management Services
    East Harftord. Ct

  4. #4
    Default
    THANK YOU - YOU SMART CODERS !

    I won this one !!

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