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Am I Confused??????

  1. #1
    Default Am I Confused??????
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    I am performing an audit and my facilities are performing basic cystoscopies 52000.. and they are coding for both 52000 AND 96372, J1580 for lidocaine administration....

    Am I the one missing something.. Lidociane is pain mgmt (local anesthesia) which is inclusive in surgeries and J1580 is gentamicin (antibiotic)... And no injection is being done what so ever during the encounter...

    What am I not understanding? Or am I correct that this should not be going on?


  2. Default
    I've seen lidocaine injections into the bladder for management of IC.

  3. #3
    Kansas City, MO
    The lidocaine is part of the procedure. You are correct. If they are not actually giving an injection of gentamycin, then billing 96372 and J1580 is fraudulant

    Karen Cross, CPC, CPMA, CEMC, CUC
    Karen Cross, CPC, CPMA, CEMC, CUC

  4. Default
    Lidocain can be given as local,subcutaneous intra muscular, regional like pudental block ; may be there was a need for that during the cystoscopy procedure for the introduction of catheter, when the patient is stressed and in fear of pain there will be problem in introduction of the catheter /cannula. I don't find a fradulance in that.

  5. #5
    Kansas City, MO
    There is if you are billing for the lidocaine seperately
    Karen Cross, CPC, CPMA, CEMC, CUC

  6. #6
    Kansas City, MO
    What I mean is if they are simply applying lidocaine in the urethra, they should NOT be billing an injection code. If they ARE injecting lidocaine then they need to document it appropriately
    Karen Cross, CPC, CPMA, CEMC, CUC

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