Wiki Charging for Botox Needle

[Savannah]

We do Botox for Dysphonia in the Office (64616 and R49.0). The provider is charging the patients for the Needle used to Administer the Botox. I have told him the Needle is included however he is adamant I am wrong. Can I please get some feedback on this. Is this documented clearly anywhere? Or am I wrong ?
Thank you for your time.

 

[mitchellde]

the supplies needed to perform a given procedure are inclusive to procedure itself. I cannot imagine that a provider would not believe this. I am sure this is stated somewhere but at present I have no reference to give you. I am sure someone out there has something that can show you where is considered inclusive.

 

[mitchellde]

I was able to find this to maybe help you out a little:
Supplies
As stated previously, Medicare does not reimburse separately for supplies for the majority of procedures performed in an office, and this includes pain management procedures. Medicare considers supplies to be bundled into the fee for the service rendered, i.e., part of the “global surgical package”. Ominipaque (Low Osmolar Contrast Material (LOCM) is a good example of this. Most Medicare carriers only cover this for intravenous, intraarterial and intrathecal injections for diagnostic purposes. See Related Change Request (CR) #: 3748 Medlearn Matters Number: MM3748 - Related CR Release Date: March 11, 2005
Related CR Transmittal #: 502
Effective Date: April 1, 2005
Implementation Date: April 4, 2005

 

[CodingKing]

NCCI manual for example lists the following as included in the global surgical package https://www.cms.gov/medicare/coding/nationalcorrectcodinited/index.html:

Chapter 0 - General coding guidelines:

Some services are integral to large numbers of procedures. Other services are integral to a more limited number of procedures. Examples of services integral to a large number of procedures include:

Surgical supplies, except for specific situations where CMS policy permits separate payment

Findacode subscription used to list supplies that were taken into consideration when setting the practice expense component of the RVU but they seemed to have pulled the more detailed info. Here is the list from 2018, click on thumbnail to expand.