Ob-Gyn Coding Alert

Not all new National Correct Coding Initiative edits affect surgical procedures -- in fact, a major NCCI 10.2 bundle involves the HCPCS code J2001 for lidocaine

"This edit does not surprise me," says Lynn M. Anderanin, CPC, senior coding consultant for Health Info Services in Des Plaines, Ill. "If a physician uses lidocaine as a local anesthetic, he or she would not be administering via intravenous infusion."

Because HCPCS deleted J2000 (Injection, lidocaine HCl, 50 cc) this year and introduced J2001 (Injection, lidocaine HCl for intravenous infusion, 10 mg) in its place, most coders take this as a sign that Medicare would no longer allow them to report lidocaine for the small amount of anesthetic that they injected for pain management. "This is a great example of why you should read and heed the descriptions," says Susan E. Callaway, CPC, CCS-P, an independent coding and reimbursement specialist and educator in North Augusta, S.C. "J2001 specifically states for intravenous infusion."

In general, Medicare does not pay surgeons for administering anesthesia, because "they feel that it is part of the global surgical package," Anderanin notes.

"Most ob-gyn practices don't bill it anyway, and even if they do, the number of insurance carriers that actually pay them is very limited," Callaway says. But a few procedures that ob-gyns perform now include the IV lidocaine code (J2001), according to the new NCCI 10.2 edits.

For example, the NCCI now bundles J2001 into the following procedures: (This is only a partial listing of the edits affecting code J2001.

For a complete list, please visit the NCCI edits on the CMS Web site at www.cms.hhs.gov/physicians/cciedits/default.asp.)