If you bill a 20610 as an aspiration not an injection you don't put any of the cains on the claim. BCBS is denying this line stating my injectable code is not listed. I have asked them to review the guidelines of the code and it is still in review but also thought about entering the lidocaine and xylocaine to the claim as a zero to get claim processed. Is anyone else having this issue and what did you do?
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Wiki 20610 Help
- Thread starter Crik
- Start date
SharonCollachi
Guest
Wow, I have never had a claim denied for lack of the injectable. If they are denying for that reason, I would put it on as a one cent code to get the claim processed.
fwnewbie
Guest
What DX are you putting with it? Joint effusion?
katemae84
Networker
Anthem BCBS in my state (Maine) requires us to submit aspirations like 20610 with J3590 (unclassified biologics) with a zero charge in order to be reimbursed effective service date of 5/1/2019 or later- I think this was pretty much an across-the-board move for Anthem, but check your local Anthem reimbursement policies. The policy change was communicated in the Provider Newsletter in Feb 2019 for us.
Following as I am getting the same denial from Empire BCBS in NY (denied for associated charge not billed).
Katemae84, thank you for that reference point, that will give me a great place to start for NY.
UPDATE: I found the documentation for NY BCBS regarding injection codes billed without a HCPC drug or injectable substance. Bottom line, no drug billed, injection code will be denied. Actually at this point they are even retracting payments previously made for injections when there is no drug billed for that same DOS.
Katemae84, thank you for that reference point, that will give me a great place to start for NY.
UPDATE: I found the documentation for NY BCBS regarding injection codes billed without a HCPC drug or injectable substance. Bottom line, no drug billed, injection code will be denied. Actually at this point they are even retracting payments previously made for injections when there is no drug billed for that same DOS.
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csardone
Contributor
We have been adding lidocaine(J0000) onto the claim with $0.01
katemae84
Networker
I see that you are from Ohio- here is the link to Ohio Anthem's website regarding the instruction to add J3590 for the aspirated contents of the syringe.
https://providernews.anthem.com/ohi...-with-related-injection-services-professional
You should never just add codes in order to get something paid. Always do your research. Make sure you are following coding guidelines, and then if the claims are still denying, start looking at the payer's reimbursement policies.
I'm having an issue with hip INJECTION under fluoro. We used 20610 and 77002, but getting denied for "77002 requires a parent code". The CPT books says to use 77002 in conjunction with a list of different codes, including 20610. Can anybody help me with this, please?
Rose Brummett, CPC, COPC
Rose Brummett, CPC, COPC
fwnewbie
Guest
Interesting. Could it be the insurance company made an error?
csardone
Contributor
We are only adding the J code if they are injecting the lidocaine first. If they do not use lidocaine and only aspirate, the insurance has to fight that. We aren't just adding codes to get paid. maybe my answering was wrongly worded.