If your doctors have participating provider Ids for each carrier, they will often allow you to download a copy of their fee schedule, type in a specific CPT code for a fee on their website, or your provider representative will get the fees you need for the CPTs you want. Sometimes this is time consuming, but will be worth the effort.
My understanding for injections is that as long as the E&M is significantly separate, modifier 25 is appropriate, so you will need to appeal on that basis. Also, you should be able to bill the E&M, administration for the drug, and the "J" code as long as you supply all the required detail. There are general rules for this, but you will have to contact the carrier to find out what they are looking for. Your insurance carrier Provider Representative is there to help, so do not be shy!
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