# Help needed for Medicare injections



## loliveri (Jun 10, 2011)

We need some help coding and billing Medicare patients that receive an injection.
We are billing out a 99213-25 ,  20605, and the meds. The problem we are having is Medicare is not allowing us to use the 715.94 Osteoarthritis of the Hand as a DX.  Do you all have another DX that is getting paid?


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## tdml97@yahoo.com (Jun 10, 2011)

According to Ingenix - that is a payable diag.  What kind of rejection are you getting?


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## mitchellde (Jun 10, 2011)

If you are giving the injection for pain then you need a pain code (338.1x or 338.2x listed first with the 715.94 listed second and link only the pain code to the 20605 and the drug.


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## loliveri (Jun 10, 2011)

tdml97@yahoo.com said:


> According to Ingenix - that is a payable diag.  What kind of rejection are you getting?



Thanks. We have had few different rejections. Anywhere from wrong DX code and second, that we should use a different procedure code.

Thanks again. 
Lisa O.


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## apmc (Jun 16, 2011)

*Where is injection?*

Hi.
We usually perform this procedure for shoulders and knees using 715.96, 715.91 without a problem but I haven't had experience with the hand. I was thinking....where exactly is the injection?  Perhaps because you are coding the 715.94 for the hand they are flagging this as a 20600 for small joint (as in fingers).  Is it possible that for the wrist (which would be billable as a 20605) the appropriate Dx would be 715.93 for the forearm?

Just a thought. Otherwise I cannot figure out for the life of me why you would not be getting paid.
Good luck!

Susan


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## gail (Sep 1, 2011)

You could be having a problem because of the 9 in the 4th digit; we use 715.14, which is more specific and is also accurate.


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