Anesthesia Coding Alert
Billing Medicare for Therapeutic Injection
Question: Under Medicare, can I bill 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) in addition to the injected drug? The patient received J3410 (Injection, hydroxyzine HCl, up to 25 mg) and J2175 (Injection, meperidine HCl, per 100 mg). New Mexico Subscriber Answer: Some Medicare carriers will allow you to bill code 90782 along with certain drug codes, as long as an office visit is not billed on the same day and there are supporting diagnosis codes. Examples of these codes are J2820 (Injection, sargramostim), J1440-1441 (Injection, Neupogen/filgrastim) and J3240 (Injection, thyrotropin alpha). Regarding J3410 and J2175, local medical review policies (LMRPs) for most carriers do not state that you cannot bill these codes together. However, you should check with your local carrier to be sure what their policies are. In addition, both codes have a quality alert and special coverage instructions. Careful attention should be made to the quantity when billing these drug codes. Answers to Reader Questions and You Be the Coder provided by Bellinger Moody, CPC, CCP, RHIH, of Medac, an Augusta, Ga.-based anesthesiology and pain management consulting firm; and Linda Runfola, CPC, of NAPA Management Services Inc. in Syracuse, N.Y.
Special coverage instructions are given in the form of CIM reference numbers in Appendix 4 of the 2002 HCPCS Level II Professional manual.
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