# HCPCS coding - I'm unsure of the HCPCS



## Brenda@wdl (Apr 30, 2009)

I'm unsure of the HCPCS codes and need assistance with this scenario: 

This 22-year-old female is a member of the tennis team at the college she is attending. She was seen two weeks ago and diagnosed with rotator cuff syndrome affecting the supraspinatus muscle … Because conservative management has not resolved the symptoms, she is seen today for a trigger point injection of the suptraspinatus muscle. The patient was seated on the exam table, bent forward, with a patient gown open in the back. The injection site was prepped. A solution of 1 mL of triamcinolone, 40 mg/mL and 2 mL of lidocaine hydrochloride 2% was injected into the supraspinatus muscle. There was minimal bleeding and sterile gauze was secured with a bandage over the site. 

Which CPT and HCPCS codes would you use?


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## RebeccaWoodward* (Apr 30, 2009)

20552
Triamcinolone (J3300-J3303  Not sure which one you used)
Lidocaine (not billable)


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## Brenda@wdl (Apr 30, 2009)

Dumb questions, I'm sure, but why isn't the lidocaine billable? I have a coder that states since it's a "solution" of the triamcinolone and lidocaine, both should be coded with HCPCS.


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## RebeccaWoodward* (Apr 30, 2009)

No such thing as a dumb question.....

J2001 (lidocaine) is administered intravenously.  The "caine" family as a whole is normally bundled into the procedure itself.


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## ckkohler (Apr 30, 2009)

I agree with Rebecca.  I currently work in a pain management/ASC provider office.  The medication USED in the injection is inclusive of the injection procedure.  I perform pre-auth's and I have to a lot of times LIST the medications used along w/a HCPCS code and NDC # - however, we do not bill separately.


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## jdrueppel (Apr 30, 2009)

We bill for "therapeutic" lidocaine (when it is part of the injectible) under the HCPCS code of J3490 with description and NDC and receive payment.  We do not bill when it's used for local anesthetic purposes.  

Julie, CPC


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## Brenda@wdl (May 1, 2009)

In this case it states: A solution of 1 mL of triamcinolone, 40 mg/mL and 2 mL of lidocaine hydrochloride 2% was injected into the supraspinatus muscle.

It seems the triamcinolone and lidocaine were combined and injected together. So, you would code separtately?


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## jdrueppel (May 1, 2009)

Yes I would.

Julie, CPC


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