Wiki bladder cocktail

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mireya77

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Does anyone know if there's some reason we cannot bill for the drugs used in the bladder cocktail (heparin, sodium bicarbonate, kenalog, marcaine...) that is instilled into the bladder for interstitial cystitis? Was told previously that we shouldn't/couldn't bill for these. Any help with this would be greatly appreciated.
 
Medicare and some PPO's will allow you to bill for the instillation of the Heparin. I bill for them all the time. However if the patient has an HMO the plans require that you order the medication from the insurance Specialty pharmacy. Meaning you can only bill for the instillation and not the drug.
 
Bladder cocktail

When the physician does a bladder cocktail what should be billed? We are billing a nurse visit and from what I'm reading we should be billing 51700 along with the heparin is that correct?
 
We bill 51700 for the instillation along with J1644-Heparin & S0020-Marcaine (medicare doesn't cover the Marcaine)
 
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