Outpatient Facility Coding Alert

Question: The gastroenterologist noted that he administered a GI cocktail. What is this, and how should we bill it?

Virginia Subscriber

Answer: A GI cocktail is a mixture of antacid, viscous lidocaine and anticholinergics that the gastroenterologist will sometimes administer orally to patients as a treatment for dyspepsia.

There is no specific code to report this mixture. You can try reporting this with 99070 (Supplies and materials [except spectacles], provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) in the professional setting or J8499 (Prescription drug, oral, non chemotherapeutic, NOS) in the ASC. However, it is most likely that payers will not reimburse for this and the cost will be included within the E/M or the procedure that was performed. Under Medicare, it is considered a self-administered drug, and therefore, non-covered.