Wiki ASC Pain Management Injection Question

[dmaclachlan]

I have coded pain management facility charges for a while and have never billed for any of the medications used in the injections. I just got a new Dr. to code for and I will be billing both professional AND facility. He did epidural injections and used Dexamethasone (J1100) and he also did some sacroiliac joint injections and he use Kenalog (J3301) for these injections. My question is this -- Is the medication included in the injection, or is it okay to bill for the medication with the professional portion of this service? I did some research and the only thing I was able to find is "caine" drugs are included and to not bill for them. But I can't find guidelines for other medications. Any light you shed on this for me will be greatly appreciated.

 

[thomas7331]

in a facility place of service, medications would always be the responsibility of and billed by the facility. Medications such as these would usually be inclusive to the surgical case rate paid to the facility and not separately reimbursed, but can still be included in the facility bill. I believe that for an ASC they would usually be rolled into the surgical charge.