# Denial N674



## cris722 (Sep 21, 2020)

Any help would be appreciated. I cannot find out any information. 


Denial code N674:  Not covered unless a pre-requisite procedure/service has been provided. 


Billed 60 yr old lady for a joint injection to the right knee. Insurance is Anthem BC/BS.

20610 RT with diagnosis code M25.561, place of service is 11.  

No other procedure code was billed on this date of service joint injection only.


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## Cynthia Hughes (Sep 22, 2020)

Was a HCPCS code reported for the drug that was injected? Some payers will deny if only the injection code is reported.


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## cris722 (Sep 23, 2020)

Cynthia Hughes said:


> Was a HCPCS code reported for the drug that was injected? Some payers will deny if only the injection code is reported.



No I did not think to use a HCPCS code.


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## Cynthia Hughes (Sep 23, 2020)

cris722 said:


> No I did not think to use a HCPCS code.


If your physician practice supplied the medication that was injected, there should be a HCPCS code for that medication. Payers also sometimes require that the HCPCS be reported with no charge when supplied by the patient (e.g., purchased at the pharmacy and brought in for injection).


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## cris722 (Sep 23, 2020)

Cynthia Hughes said:


> If your physician practice supplied the medication that was injected, there should be a HCPCS code for that medication. Payers also sometimes require that the HCPCS be reported with no charge when supplied by the patient (e.g., purchased at the pharmacy and brought in for injection).




Thank you.  We did supply the medication Decadron.  So I should have also billed J1100 with the 20610?


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## Cynthia Hughes (Sep 23, 2020)

cris722 said:


> Thank you.  We did supply the medication Decadron.  So I should have also billed J1100 with the 20610?


Yes, you report the medication code with units based on the code descriptors (so for J1100 report 1 unit per 1mgJ).


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## cris722 (Sep 23, 2020)

Cynthia Hughes said:


> Yes, you report the medication code with units based on the code descriptors (so for J1100 report 1 unit per 1mgJ).




Thank you so much for taking the time to help me.   I really appreciate it.


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