Primary Care Coding Alert

Question: Since HCPCS deleted J2000, does a code exist for a lidocaine injection - other than for IV infusion?


Michigan Subscriber

Answer: No. HCPCS did not create a code to replace J2000 (Injection, lidocaine HCl, 50 cc).

Surprise: The code's 2004 deletion without replacement makes sense. Physicians or nurses typically inject lidocaine as a topical anesthetic.

Problem: The CPT surgical package includes topical anesthesia. Therefore, you should not usually separately report a lidocaine injection.

In fact, Medicare never intended J2000 for anesthetic use. The dose's large increment - 50 cc - implies you should have instead used the code for cardiac arrhythmia (427.9) and emergency treatment. A local anesthetic typically requires only 1-2 cc.

Solution: If you use lidocaine as an anesthetic, consider the injection a component of the medical procedure, such as 20552 (Injection[s]; single or multiple trigger point[s], one or two muscle[s]). Example: A patient receives a lidocaine injection prior to a family physician giving her a trigger point injection in the abdomen wall. Report 20552 for the TPI, but not J2000.