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Am I Confused?????? - they are coding

  1. #1
    Default Am I Confused?????? - they are coding
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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. #2
    Kansas City, MO
    You are absolutely correct. I work for a urology group, and sometimes the nurse WILL give an injection of gentamycin as prophylactic before a procedure, but it is clearly documented in the notes. Do you think they might be giving an ijection and are not documenting it? If not, they should NOT be billing 96372 & J1580 with 52000

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

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