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new code 96372

  1. #1
    Default new code 96372
    Exam Training Packages
    can J2001, 20605 and 20610 be coded with this new code?
    New to orthopedics.

  2. #2
    Location
    Columbia, MO
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    20605 and 20610 are joint injection codes, the 96372 is for sq or IM injections, very different issues. They are not used together for the same injection. The 20610 or 20605 are the admin codes for the joint injection the J code is the drug/substance injected. The 96372 is not coded for a joint injection.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    albuquerque
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    The 20605 and 20610 are joint injections
    Angelica Stephens RHIT, CPMA, COSC, CCS-P, CPC, COC.
    Albuquerque, NM

  4. #4
    Location
    North Carolina
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    Also...J2001 is for intravenous infusion. Many carriers do not reimburse for the other "caine" family codes.

  5. #5
    Location
    Macon Local Chapter 2016 President Elect
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    8
    Default new code 96372
    Per the CPT 20600, 20605 and 20610 is for either the aspiration and/or injection of a joint. The CPT code 20600 for small joint, 20605 medium joint and 20610 for a large joint. You would never bill J2001 which is for "IV Lidocaine" not for numbing the patient during arthrocentesis. Carriers already factor payment for Lidocaine into the fee schedule. Please read except from Palmetto Medicare dated 8-26-09:

    Lidocaine: Bundling Denials

    •HCPCS code: J2001
    Resolution/Resources:
    •HCPCS code J2001 is bundled with surgical procedures and is not separately reimbursed
    Reference:

    •CMS Pub. 100-04 chapter 12 section 50 (PDF, 902 KB)

    I agree that since 20610 is for the adminisration of a medication you would not double bill the carrier for the administration with 96372 unless a separate injection is given, in a separate part of the body unrelated to arthrocentesis such as an antiobitic IM.

    I hope that helps!

  6. #6
    Location
    Columbia, MO
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    Quote Originally Posted by rebeccawoodward View Post
    Also...J2001 is for intravenous infusion. Many carriers do not reimburse for the other "caine" family codes.
    Thanks Rebecca, someone left with my HCPC book and I did not recognize this as the code for lidocaine since we never use it. You are right it is IV. If you are giving lidocaine as a comfort measure in addition to a therapeutic drug, it may not be billed. If the physician is injecting lidocaine into the joint (??) as a therapeutic measure for ... pain(?), you will need use an unspecified J code.
    I was adressing the use of the 96372 with the joint injection codes. The billing service I did consulting for had instructed all their coders to use both together for joint injections. It took forever to retrain the coders to not do that.

    Debra A. Mitchell, MSPH, CPC-H

  7. #7
    Location
    North Carolina
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    I completely understand, Debra...about retraining staff. Many moons ago, we had an employee who instructed the staff to append modifier 59 to J2001. When I questioned her reasoning, the answer was "to get it paid". When I explained the method of how it is administered and the bundling issues...the comment was "if it's paid, it's billable". I felt like I was in the twilight zone.

  8. #8
    Default Thank you every one
    I am so luck to have the wealth of all your knowledge available to me. Thank you

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