Wiki Coding 20610

[BrettAAPC]

Hi,

I am currently on a patient with a 20610 RT and 99204 (25), but my question was about the coding of the 40 mg depo medrol and 10 ml of bupivicaine. Does anyone know if I am supposed to code these with a J code or if it is included in the 20610 code?

 

[Walker22]

I always list the Depo as a separate line item on the claim. Sometimes it gets bundled, sometimes not. If the Bupi is being used for local anesthesia, it is included and I don't list it separately.

 

[dwaldman]

Need to confirm who has purchased the depo medrol. If this was performed in a hospital setting then the hospital would bill for the J code. If this is a office setting then you would be able to separately report, if the physician or practice incured the cost of the drug. As seen below the J1030 with quantity one would indicate that 40 mg of the steroid was adminstered. You might run in to a carrier who requires you to provide the NDC number which can be found on the packaging box or drug bottle. What I typically see on coding forums is that the bupivicaine is usually not worth trying to get reimbursed. But you will always see one or two responses that describe using unlisted J3490 or S0020 and they indicate they are being reimbursed. Typically there is only so much time in the day to do follow up so I have forgone billing the "caine" portion in the past.

HCPCS J1030
Injection, methylprednisolone acetate, 40 mg

 

[Walker22]

Agree with dwaldman... my response was based on an assumption that the service was being provided in the providers office, not a facility.

 

[BrettAAPC]

thank you very much for your responses, they've been helpful.