Results 1 to 6 of 6

Help needed for Medicare injections

  1. Default Help needed for Medicare injections
    Medical Coding Books
    We need some help coding and billing Medicare patients that receive an injection.
    We are billing out a 99213-25 , 20605, and the meds. The problem we are having is Medicare is not allowing us to use the 715.94 Osteoarthritis of the Hand as a DX. Do you all have another DX that is getting paid?

  2. Default
    According to Ingenix - that is a payable diag. What kind of rejection are you getting?

  3. #3
    Columbia, MO
    If you are giving the injection for pain then you need a pain code (338.1x or 338.2x listed first with the 715.94 listed second and link only the pain code to the 20605 and the drug.

    Debra A. Mitchell, MSPH, CPC-H

  4. Default
    Quote Originally Posted by View Post
    According to Ingenix - that is a payable diag. What kind of rejection are you getting?
    Thanks. We have had few different rejections. Anywhere from wrong DX code and second, that we should use a different procedure code.

    Thanks again.
    Lisa O.

  5. #5
    Default Where is injection?
    We usually perform this procedure for shoulders and knees using 715.96, 715.91 without a problem but I haven't had experience with the hand. I was thinking....where exactly is the injection? Perhaps because you are coding the 715.94 for the hand they are flagging this as a 20600 for small joint (as in fingers). Is it possible that for the wrist (which would be billable as a 20605) the appropriate Dx would be 715.93 for the forearm?

    Just a thought. Otherwise I cannot figure out for the life of me why you would not be getting paid.
    Good luck!


  6. Default
    You could be having a problem because of the 9 in the 4th digit; we use 715.14, which is more specific and is also accurate.

Similar Threads

  1. SI joint injections + Medicare
    By Candylcook in forum Medicare Regulations
    Replies: 0
    Last Post: 08-07-2013, 06:47 PM
  2. Medicare and Injections
    By excelortho in forum Orthopaedics
    Replies: 4
    Last Post: 02-08-2013, 03:06 PM
  3. Medicare/Pain injections
    By TLVANDERPOOL in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 06-21-2010, 11:23 AM
  4. Replies: 5
    Last Post: 03-10-2009, 10:42 AM
  5. Replies: 0
    Last Post: 03-05-2009, 03:44 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?


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.