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Thread: E&M w/ high end injectables or steroids

  1. #1
    Join Date
    Apr 2007
    Seattle First Hill

    Smile E&M w/ high end injectables or steroids

    AAPC: Back to School
    A lot of of our Dr's will use high end injectables ie:Synvisc, Hyalgan, Orthovisc or Euflexxa and the rule of thumb at our practice is that if Dr. discussed the use of injections at a prior visit within 3 months of the injections, then we do not assign an E&M code. However if the Dr. injects a steroid ie:Kenalog, Celestone, Depo Medrol then we do assign an E&M. Is this a correct pratice? What do you do in your practice regarding E&M's and injections? Thank you for your advice!

  2. #2

    Default injections

    At our office, if using the viscosupplements, we do not bill an E/M with the injection. I believe if you see the patient and are able to start the visco, you can though using a modifier. We do not keep it stocked in the office so that's not a common thing for us. Using the "regular" anti-inflammatories, we bill the E/M.

  3. #3
    Join Date
    Apr 2007
    Seattle First Hill


    Thank you for your response, it is most helpfull!!

  4. #4


    I know this post was from a while back, but I figured I'd respond.... For Visco injections, they're USUALLY planned. If it's known that the patient is coming in for Depomedrol, Kenalog, etc. or even Visco Supplementation, we don't charge for the E/M. For example. I actually just read a note this morning that said the patient couldn't get authorization for Orthovisc, so they wanted a Depomedrol injection. In that case, I didn't charge for the E/M because they knew that's what the patient was coming in for.

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