Nvgrant
New
Hi all
I asked this question in the Ophthalmology thread since that's my provider's specialty. But, you guys may have better insight on these procedures. I have a provider in my clinic that's started doing greater occipital nerve blocks. He's using a mixture of Kenalog, bupivacaine, and bacteriostatic normal saline. I'm not sure what J codes to use. I reached out to the American Academy of Ophthalmology (AAO), and they recommended J3490 or J7999. I've tried J7999 and I'm getting denials. Would it be better to list each drug with it's J-code separately? What do you guys think?
Description of Procedure:
The procedures and risks were explained in detail. Questions were encouraged and answered. The correct patient was identified. The correct site and side were confirmed. After reviewing risks, benefits and alternatives, the patient wishes to proceed. Consent was obtained.
Correct patient and side were identified and marked. The patient was placed in the seated position and asked to assume a chin down head position.
40mg/1cc Kenalog was diluted with 1cc of bacteriostatic normal saline. 1cc of 0.5% bupivacaine was then added. 3cc of this mixture was then drawn into a 3cc syringe with a 25-gauge needle. An alcohol swab was used to clean skin edge at skull base over the greater occipital nerve.
1.5cc of the total mixture was given at the right occipital nerve exit from the skull overlying an area of marked tenderness to palpation which was 1/3 of the distance from the occipital notch to the mastoid process on the right side for a total of 10mg of Kenalog at this location.
The identical procedure, a left occipital nerve block, was performed in steps detailed above.
The patient tolerated well and there were no complications.
I asked this question in the Ophthalmology thread since that's my provider's specialty. But, you guys may have better insight on these procedures. I have a provider in my clinic that's started doing greater occipital nerve blocks. He's using a mixture of Kenalog, bupivacaine, and bacteriostatic normal saline. I'm not sure what J codes to use. I reached out to the American Academy of Ophthalmology (AAO), and they recommended J3490 or J7999. I've tried J7999 and I'm getting denials. Would it be better to list each drug with it's J-code separately? What do you guys think?
Description of Procedure:
The procedures and risks were explained in detail. Questions were encouraged and answered. The correct patient was identified. The correct site and side were confirmed. After reviewing risks, benefits and alternatives, the patient wishes to proceed. Consent was obtained.
Correct patient and side were identified and marked. The patient was placed in the seated position and asked to assume a chin down head position.
40mg/1cc Kenalog was diluted with 1cc of bacteriostatic normal saline. 1cc of 0.5% bupivacaine was then added. 3cc of this mixture was then drawn into a 3cc syringe with a 25-gauge needle. An alcohol swab was used to clean skin edge at skull base over the greater occipital nerve.
1.5cc of the total mixture was given at the right occipital nerve exit from the skull overlying an area of marked tenderness to palpation which was 1/3 of the distance from the occipital notch to the mastoid process on the right side for a total of 10mg of Kenalog at this location.
The identical procedure, a left occipital nerve block, was performed in steps detailed above.
The patient tolerated well and there were no complications.