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Payments on injectibles

  1. #1
    Default Payments on injectibles
    Medical Coding Books
    As I am posting payments I am noticing a trend on lidocaine and marcaine not getting paid. Is there a reason for this?

    Thanks

    A newbie

  2. Default
    What kind of rejections are you getting??? What insurance???


  3. #3
    Default
    Medicare saying it is a part of another service, I believe blue cross/blue shield is saying it as well.

  4. Default
    OK, give me an example of what you are billing out

  5. #5
    Default
    99212, 20610, j2001, j7321
    or
    99212, 20610, j2001, j1030

    thank you for the help

  6. #6
    Default
    Also 99213, 20551. 20610, j0702, j2001, j1030

  7. Default
    Are you using any modifiers???


    This is how I bill out mine:

    99213-25 - 4011
    20550 - 72610
    J1030 - 72610

    Which code are they saying is inclusive?

  8. #8
    Default
    It is just the J2001 and J0670 when used in combination with another injectible. I have seen one case the only injectible used was lidocaine and it got paid.
    Yes we always use the mod 25 on the OV code.

  9. Default
    Have you tried a mod 59 on the injections?

  10. #10
    Default
    Yes. No luck. After google I am reading it is not payable if used in conjucuntion with another drug for comfort.

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