Urology Coding Alert

Question: Now that the temporary injection codes G0356, G0351 and G0347 have been replaced with new codes, can the new codes be billed with office visits the same way the G codes could be?


Michigan Subscriber

Answer: The same rules apply to the new injection codes that applied to the G codes. You can report a separately identifiable E/M service with the new injection codes using modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

Pitfall: The exception is 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician), which you cannot ever report with any of the injection codes because the work RVUs are similar and are already factored in to the injection code. So, if you have an E/M service, higher than a level one, that you can show is separate from the injection service, you may use modifier 25 and report both services.