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HCPCS coding - I'm unsure of the HCPCS

  1. Default HCPCS coding - I'm unsure of the HCPCS
    Medical Coding Books
    I'm unsure of the HCPCS codes and need assistance with this scenario:

    This 22-year-old female is a member of the tennis team at the college she is attending. She was seen two weeks ago and diagnosed with rotator cuff syndrome affecting the supraspinatus muscle … Because conservative management has not resolved the symptoms, she is seen today for a trigger point injection of the suptraspinatus muscle. The patient was seated on the exam table, bent forward, with a patient gown open in the back. The injection site was prepped. A solution of 1 mL of triamcinolone, 40 mg/mL and 2 mL of lidocaine hydrochloride 2% was injected into the supraspinatus muscle. There was minimal bleeding and sterile gauze was secured with a bandage over the site.

    Which CPT and HCPCS codes would you use?

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    20552
    Triamcinolone (J3300-J3303 Not sure which one you used)
    Lidocaine (not billable)

  3. Default
    Dumb questions, I'm sure, but why isn't the lidocaine billable? I have a coder that states since it's a "solution" of the triamcinolone and lidocaine, both should be coded with HCPCS.
    Last edited by Brenda@wdl; 04-30-2009 at 09:55 AM.

  4. #4
    Location
    North Carolina
    Posts
    3,126
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    No such thing as a dumb question.....

    J2001 (lidocaine) is administered intravenously. The "caine" family as a whole is normally bundled into the procedure itself.

  5. #5
    Location
    Omaha, Nebraska
    Posts
    143
    Default
    I agree with Rebecca. I currently work in a pain management/ASC provider office. The medication USED in the injection is inclusive of the injection procedure. I perform pre-auth's and I have to a lot of times LIST the medications used along w/a HCPCS code and NDC # - however, we do not bill separately.
    Carolyn Kohler, CPC
    Omaha, NE

  6. #6
    Default
    We bill for "therapeutic" lidocaine (when it is part of the injectible) under the HCPCS code of J3490 with description and NDC and receive payment. We do not bill when it's used for local anesthetic purposes.

    Julie, CPC
    Last edited by jdrueppel; 04-30-2009 at 08:01 PM.

  7. Default
    In this case it states: A solution of 1 mL of triamcinolone, 40 mg/mL and 2 mL of lidocaine hydrochloride 2% was injected into the supraspinatus muscle.

    It seems the triamcinolone and lidocaine were combined and injected together. So, you would code separtately?

  8. #8
    Default
    Yes I would.

    Julie, CPC

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