Results 1 to 6 of 6

Am I Confused??????

  1. #1
    Default Am I Confused??????
    Medical Coding Books
    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?

    Thanks!

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

  3. #3
    Location
    Kansas City, MO
    Posts
    37
    Default
    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
    Location
    Kansas City, MO
    Posts
    37
    Default
    There is if you are billing for the lidocaine seperately
    Karen Cross, CPC, CPMA, CEMC, CUC

  6. #6
    Location
    Kansas City, MO
    Posts
    37
    Default
    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

Similar Threads

  1. Confused!
    By nonadianne in forum Diagnosis Coding
    Replies: 1
    Last Post: 07-11-2012, 10:04 AM
  2. Am I Confused?????? - they are coding
    By LewinFamily in forum Auditing General Discussion
    Replies: 1
    Last Post: 11-10-2010, 12:29 PM
  3. Am I Confused?????? - local anesthesia
    By LewinFamily in forum Anesthesia
    Replies: 3
    Last Post: 10-27-2010, 08:23 PM
  4. Am I Confused?????? - basic cystoscopies
    By LewinFamily in forum Billing/Reimbursement
    Replies: 1
    Last Post: 10-27-2010, 06:37 PM
  5. Am I Confused??????
    By LewinFamily in forum General Surgery
    Replies: 0
    Last Post: 10-27-2010, 01:24 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.