Urology Coding Alert

Question: I’m new to urology coding and billing. My doctor uses lidocaine jelly 2 percent for most of her office procedures, including the insertion of Foleys. She wants to bill separately for this lidocaine jelly. I’ve tried looking for the HCPCS Level II code for this but cannot find it. Is this something that is separately reimbursable?

AAPC Forum Participant

Answer: No, lidocaine gel or jelly cannot be reported separately because in most scenarios, supplies are included in the CPT^® codes.

Take Note: If your urologist uses lidocaine injections, they are not separately reported. Medicare specifies that local anesthetic use is “an inherent surgical procedure component and is not billable separately.”

Medicare includes all “surgical anesthesia” administered by the operating surgeon as part of the surgical package and not a payable service. There are many private, non-Medicare or commercial insurance carriers, however, that will pay for anesthesia blocks but not for topical or local anesthesia. For these carriers, you can separately bill for any anesthesia blocks administered by the operating surgeon.