Anesthesia Coding Alert

Code 20526 doesn't automatically point to a certain medication.

When you code for therapeutic carpal tunnel (CT) injections with 20526 (Injection, therapeutic [e.g., local anesthetic, corticosteroid], carpal tunnel), experts say to pay close attention to the specific drug type and amount before finalizing your claim.

Explanation:  Accurate coding of drug supply will garner you more pay for your 20526 encounters. "All providers should bill for the drug supply separately, paying close attention to the dosage to make sure they are coding the correct units," confirms Dreama Sloan-Kelly, MD, CCS, president of Dr. Sloan-Kelly Consulting in Shirley, Mass.

According to Catherine Forman, DC, CPC, COSC, CMC, of University Orthopaedic Associates URMC in Rochester, NY, most 20526 encounters will involve one of the drug supply codes listed below. Check out this list of medications that your provider might inject during a 20526 encounter:

• J0702 – Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
• J1020 – Injection, methylprednisolone acetate, 20 mg 
• J1030 – Injection, methylprednisolone acetate, 40 mg
• J1040 – Injection, methylprednisolone acetate, 80 mg 
• J1094 – Injection, dexamethasone acetate, 1 mg
• J1100 – Injection, dexamethasone sodium phosphate, 1 mg
• J1700 – Injection, hydrocortisone acetate, up to 25 mg
• J1710 – Injection, hydrocortisone sodium phosphate, up to 50 mg
• J1720 – Injection, hydrocortisone sodium succinate, up to 100 mg
• J2920 – Injection, methylprednisolone sodium succinate, up to 40 mg
• J2930 – Injection, methylprednisolone sodium succinate, up to 125 mg
• J3301 – Injection, triamcinolone acetonide, not otherwise specified, 10 mg
• J3302 – Injection, triamcinolone diacetate, per 5 mg
• J3303 – Injection, triamcinolone hexacetonide, per 5 mg.

When you are reporting 20526, remember to include a drug supply code, Forman reminds.

"All providers should bill for the drug supply separately - paying close attention to the dosage to make sure they are coding the correct units," explains Sloan-Kelly. "The most common injectable used for 20526 is J1030 [Injection, methylprednisolone acetate, 40 mg]."