Take 5 Simple Steps to Solidify B-12 Payments In 2006
Published on Sun Jan 01, 2006
Understand the basics of reporting the new streamlined injection codes
Code 90782 ranks in the top-15 codes reported by family physicians--so it is crucial that you keep payment flowing for these claims using the new 2006 coding method that takes effect Jan. 1.
Old way: In 2005, Medicare issued a temporary G code to replace CPT's therapeutic injection code. For administration of a B-12 injection (J3420, Injection, vitamin B-12 cyanocobalamin, up to 1,000 mcg), you had to report G0351 to Medicare and 90782 for private insurers.
New way: CPT 2006's introduction of one new injection code (90772) ends the dual reporting that therapeutic injection services required and counts antibiotic injections as the same procedure.
The change will make coding injection administration easier, says Donna Struve, CPC, assistant manager for Sheldon Family Practice in Sheldon, Iowa. -Coders will no longer have to split out injection administration based on insurer.-
Take these steps to ensure you incorporate all the changes. Step 1: Replace 90782, 90788 and G0351 With 90772 The first step you should take is to remove these injection administration codes, which will be deleted from CPT 2006, from your encounter sheet:
- 90782--Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular
- 90788--Intramuscular injection of antibiotic (specify). HCPCS 2006 should also delete:
- G0351--Therapeutic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular. New method: Instead of choosing among 90782, 90788 and G0351 for injection administration, you should use a single code:
- 90772--Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular.
Important: Although 90772's descriptor doesn't specify -antibiotic,- CPT confirms that you should report injection administration of an antibiotic with 90772. -90788 has been deleted. To report, use 90772,- states CPT's notes following the -Therapeutic, Prophylactic, and Diagnostic Injections and Infusions- subsection.
Because CPT 2006 lumps therapeutic, prophylactic, diagnostic and antibiotic injections together, -coders will be able to remember one code for injection administration,- Struve says. You-ll also no longer have to determine whether to classify a particular drug, such as Rocephin, as 90782 or 90788. Step 2: Ensure FP's Presence in Office Suite Before using 90772, make sure a family physician provides direct supervision throughout the procedure. CPT has added this requirement in an instruction following 90772 that states you should -not report 90772 for injections given without direct physician supervision.-
If the injection administration encounter does not meet the direct supervision criteria, you should instead report 99211, according to CPT's instructions following 90772. The directive indicates that -CPT has adopted CMS- direct supervision definition,- says Quinten A. Buechner, MS, MDiv, CPC, president of ProActive Consultants LLC in Cumberland, Wis.
Translation: The physician must be in the office setting and immediately available. The requirement does not mean the FP must be present in [...]
