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Injection-Keloid Scar

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Exclamation Injection-Keloid Scar
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    My provider administered a steriod injection into a keloid scar to try to make it go away. My question is, what CPT code do you use to report this? Do you report 96372 for the injection and the J code for the medication, or is there a specific CPT code for this type of injection?

    Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. Default Injection-Keloid Scar
    We bill 64999 for the injection into the scar. Refer to CPT Assistant Sept. 2010 vol. 20, issue 9. We also bill for the administration and medication uses.

    Alicia, CPc

  3. #3
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks Alicia.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  4. #4
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    I just want to make sure that I understand. You report 64999 and 96372, or 64999 includes 96372? Can someone please clarify? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. Default Injection-Keloid Scar
    You would report both codes, 96372 and 64999 and since it is unlisted we also send the notes.

    Alicia, CPC

  6. #6
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks so much! I think I got it!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  7. Default
    11900

  8. Default Keloid - Scar Injection
    The use of the unlisted procedure code (64999) will raise eyebrows; especially if you don't have a charge associated with that particular code. Make sure you have a charge linked to 64999 or it won't get paid. I feel 96372 (along with the J-codes) is appropriate enough for proper charge capture and reimbursement, but as Alicia suggests, forwarding notes is also an important consideration for reimbursement of 64999 if used.

    What does the community say?

    Thanks,
    Andre, CPC

  9. #9
    Location
    Jacksonville, FL River City Chapter
    Posts
    74
    Default
    Quote Originally Posted by aschaeve View Post
    We bill 64999 for the injection into the scar. Refer to CPT Assistant Sept. 2010 vol. 20, issue 9. We also bill for the administration and medication uses.

    Alicia, CPc
    That CPT Assistant pertained to injection of a PAINFUL scar to control the pain--hence the 6X,XXX-series code.

    For injection of steroid into a keloid to dissolve the scar, CPT Assistant says to use 11900 as an above poster noted.

    From the September 1996 CPT Assistant, p. 5:

    Lesions of the integumentary system, such as keloids, psoriasis, acne (cystic or nodular), and others may be treated by injecting drugs directly into the lesion itself. To report the treatment of these lesions you would use the following codes:

    11900Injection, intralesional; up to and including seven lesions
    11901more than seven lesions

  10. Default
    I also use 11900 and J3301 for the injection.

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