Orthopedic Coding Alert

Reader Question:

Billing for ESI Trays

Question: Our pain management specialist is now doing ESIs (epidural steroid injections) at our facility. Should I bill separately for surgical trays, or are they included with the ESI?

Arizona Subscriber  
Answer: If you review the American Academy of Orthopedic Surgeons global service data for orthopedic surgery, you will see that supplies and medications, reported with 99070, are not included in the global service package, so the AAOS would certainly support billing for the surgical tray. Medicare, as is often the case, is a different story. Your local Medicare carrier has jurisdiction over payment for a surgical tray, reported with HCPCS code A4550. Check with your carrier if you provide these services to Medicare beneficiaries.
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