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Thread: Need help with coding this for Injection

  1. #1
    Join Date
    Apr 2007
    Duluth, MN

    Default Need help with coding this for Injection

    AAPC: Back to School
    Below is the note from the MD. The coding for it was as follows. Getting denial from insurance not liking the ICD-9 Codes
    215.2 and 354.9

    20552 and J3490 x 3 (unlisted Medication and Box 19 was completed)

    Any and all help would be greatly appreciated.


    Pt has a neuromatous lesion on the right elbow. It is just medial to the olecranon on the lateral aspect in between the lateral epicondyle and the olecranon. It has been diagnosed previously with the use of local anesthetic. She is in for a Sarapin injection.

    EXTREMITIES: A small fibrotic neuromatous like lesion can be palpated which is the point of tenderness. She has full motion. Her hand is neurovascularly intact.

    We discussed the treatment. She elected to go with a trial of Sarapin injection, which is a pitcher plant extract in alcohol base used for neuralgias and neuromas. Three cc of Sarapin were infiltrated around the neuromatous lesion and we hope this offers relief. If it does this can be done as frequent as needed. Follow-up on a p.r.n. basis.

    Neuroma, right elbow.
    Tina Wosmek CPC, COSC

  2. #2
    Join Date
    Apr 2007
    Kansas City


    If it is CMS/Medicare I'd look at the LCD from your carrier and if any insurance company that follows Medicare guidelines will probably follow the LCD also.

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