Anesthesia Coding Alert

Question: How should we code and submit for the administration of intranasal lidocaine? The patient has chronic migraine headaches.

Kansas Subscriber

Answer: For a patient with migraines (e.g., 346.90, Migraine, unspecified, without mention of intractable migraine), the first question the coder should ask is, "Was the lidocaine administered through injection or through inhalation?" This information should be noted on the claim form along with unlisted-procedure code 30999 (Unlisted procedure, nose). The usual drug code associated with the procedure is J2000 (Injection, lidocaine HCl).

Many commercial carriers will cover the intranasal administration procedure, but Medicare carriers will not usually provide reimbursement unless there is additional documentation submitted with the claim clarifying the medical necessity.