Wiki E&M w/ high end injectables or steroids

caskln1

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Carson City, NV
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A lot of of our Dr's will use high end injectables ie:Synvisc, Hyalgan, Orthovisc or Euflexxa and the rule of thumb at our practice is that if Dr. discussed the use of injections at a prior visit within 3 months of the injections, then we do not assign an E&M code. However if the Dr. injects a steroid ie:Kenalog, Celestone, Depo Medrol then we do assign an E&M. Is this a correct pratice? What do you do in your practice regarding E&M's and injections? Thank you for your advice!
 
injections

At our office, if using the viscosupplements, we do not bill an E/M with the injection. I believe if you see the patient and are able to start the visco, you can though using a modifier. We do not keep it stocked in the office so that's not a common thing for us. Using the "regular" anti-inflammatories, we bill the E/M.
 
I know this post was from a while back, but I figured I'd respond.... For Visco injections, they're USUALLY planned. If it's known that the patient is coming in for Depomedrol, Kenalog, etc. or even Visco Supplementation, we don't charge for the E/M. For example. I actually just read a note this morning that said the patient couldn't get authorization for Orthovisc, so they wanted a Depomedrol injection. In that case, I didn't charge for the E/M because they knew that's what the patient was coming in for.
 
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