You Be the Coder:
Bundling Marcaine
Published on Tue Aug 01, 2000
Question: Which J-codes should be used for coding an injection of Marcaine? Is there a different code to bill for Medicare patients?
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Answer: Marcaine is one of many local anesthetics generally used in minor surgical procedures, says Susan Callaway-Stradley, a coding and reimbursement specialist in North Augusta, S.C. As such, it is considered bundled into the reimbursement for the surgical procedure based on CPT definition, which states that the surgical package includes local infiltration, metacarpal/digital block or topical anesthesia when used . . . and should not be billed. This rule is consistent with commercial carriers and Medicare. If you wish to track this drug internally for records keeping without billing insurance carriers, use J3490 (unclassified drugs), with a zero dollar value.
