Primary Care Coding Alert

Question: When using 90782 for injection administration, can I use this multiple times with multiple injections or only once?

New Jersey Subscriber

Answer: Code 90782 (Therapeutic, prophylactic or diagnostic injection ...; subcutaneous or intramuscular) is only reimbursed if there are no other services payable for that patient encounter. If the physician provides other services, injections are bundled into the physician services. When he administers a noncovered drug, both the drug and administration are noncovered. 
  
Some coders recommend that you report 90782 for each injection given. For example, suppose a nurse administers two separate injections of vitamin B12 and iron. You should report 90782 x 2.
  
However, Medicare and other local medical review policies will pay this only once per encounter, regardless of how many injections were given. If commercial insurance pays this multiple times, you should use modifier -76 (Repeat procedure by same physician) on the second code.
  
For example, First Coast Florida LMRP specifies that you can report multiple administrations with chemotherapy administration only if two separate IV routes are established.

- You Be the Coder and Reader Questions answered by Susan Callaway, CPC, CCS-P, an independent coding consultant and educator in North Augusta, S.C.; Tammy Trench, CPC, accounts receivable technical adviser at Apex Practice Management in Oklahoma City; and Catherine Brink, CMM, CPC, president of Healthcare Resource Management Inc. in Spring Lake, N.J.