Neurology & Pain Management Coding Alert

Question: Can our nurse provide Solu-Medrol to patients in the office, and, if so, must the neurologist be present during the administration?


Virginia Subscriber

Answer: A nurse may administer Solu-Medrol, but the physician must be present in the office suite and immediately available to furnish assistance and direction (that is, direct supervision) during the infusion. The physician does not need to be present in the room when the procedure is performed.

There is no code to report this service if performed by a nurse without physician supervision, and reimbursement will likely be denied if the physician's presence is not clearly noted in the accompanying documentation.

To report the infusion, use 90780 (IV infusion for therapy/diagnosis, administered by physician or under direct supervision of physician; up to one hour) for the first hour and, if necessary, +90781 (... each additional hour, up to eight [8] hours [list separately in addition to code for primary procedure]) for each additional hour.

You can bill for the drug with HCPCS code J2920 (Injection, methylprednisolone sodium succinate, up to 40 mg) or J2930 (... up to 125 mg), depending on the dosage.