Primary Care Coding Alert

Question: Would you clarify when I should report J3490 for Marcaine?

North Carolina Subscriber

Answer: If your FP injects Marcaine as a local anesthetic during a surgical procedure, such as a trigger point injection (20552-20553, Injection[s]; single or multiple trigger point[s] ...), most payers will include the supply with the injection code. They base their bundle on CPT's surgical package definition, which includes "local infiltration, metacarpal/metatarsal/digital block or topical anesthesia." Some carriers may suggest that you report J3490 (Unclassified drugs) or S0020 (Injection, bupivicaine HCl, 30 ml) for tracking purposes.

But you may separately report therapeutic injectable supplies, such as steroids. For instance, if your FP injects a wrist tendon (20551, ... tendon origin/insertion) with a corticosteroid, such as Depo-Medrol (J1020, Injection, methylprednisolone acetate, 20 mg; J1030, Injection, methylprednisolone acetate, 40 mg; J1040, Injection, methylprednisolone acetate, 80 mg) or triamcinolone (J3302, Injection, triamcinolone diacetate, per 5 mg), you should bill for the procedure (20551) and the drug (J1020-J1040, J3302).