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charging for trays, needles , ect..

  1. #1
    Default charging for trays, needles , ect..
    Medical Coding Books
    When doing in office (POS 11) epidurals and such, can you charge HCPS codes for the surgical tray and things used related to the procedure?

  2. #2
    Louisville, KY
    As long as those items were purchased by the provider and there is no clinic "facility fee" (e.g., hospital-based clinic type).

  3. #3
    Thank you!

  4. #4
    If there is truly a procedure being performed, these items are included in the surgical package per the CPT code book, page 45 of the CPT 2008 Professional Edition, surgery guidelines, under the header "Materials Supplied by Physician". The supplies used must be "over and above" those usually used for a procedure in order to capture reimbursement.

    The RVU's that are placed on each code are higher for some procedures done in the office setting to offset the cost of such items.

    Hope this helps

  5. Default
    Where would it be documented that supplies were "over and above" the procedure? Should the physician document in the patient's record? I'm assuming that our physician's injections would include the trays, but he has written that these should be separate charges.

  6. #6
    I would think that for the types of cases you mention, that there will not be any over and above...but I suppose if he does an epidural that normally he uses two needles for, but for some reason had to use 4, then you could charge for the two extra needles. (he can not count them if they are wasted because of contamination, dropping on floor, etc..he has to eat those..his fault)

    Make sense?

  7. Default
    Yes, it does. I'm glad there are more experienced people on here to help. This physician gives Facet injections. I was having such a hard time finding a place that explained things further in writing. The CPT book was not too specific on this. Thanks.

  8. #8
    I don't bill for any trays used. In the past they did and were never reimbursed. My understanding is it's included. I've never seen anything over and above being allowed.
    adrianne, cpc

  9. Default
    Thanks for the info. I'm fairly new at this. Do any of you who bill for pain management injections also do fluroscopy? I wasn't sure if I should be billing 77003 twice when the physician does two different injections in two diffeent areas or should it be billed once for that session? I couldn't find information anywhere on that.

  10. #10
    Per the 2008 Interventional Radiology Coder:
    "Submit fluoro or CT guidance code only once per procedure regardless of how many levels are studied. Verify with 3rd party payer policy on whether multiples of the guidance code may be used"

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