Wiki Help needed for Medicare injections

[loliveri]

We need some help coding and billing Medicare patients that receive an injection.
We are billing out a 99213-25 , 20605, and the meds. The problem we are having is Medicare is not allowing us to use the 715.94 Osteoarthritis of the Hand as a DX. Do you all have another DX that is getting paid?

 

[tdml97@yahoo.com]

According to Ingenix - that is a payable diag. What kind of rejection are you getting?

 

[mitchellde]

If you are giving the injection for pain then you need a pain code (338.1x or 338.2x listed first with the 715.94 listed second and link only the pain code to the 20605 and the drug.

 

[loliveri]

According to Ingenix - that is a payable diag. What kind of rejection are you getting?

Thanks. We have had few different rejections. Anywhere from wrong DX code and second, that we should use a different procedure code.

Thanks again.
Lisa O.

 

[apmc]

Where is injection?

Hi.
We usually perform this procedure for shoulders and knees using 715.96, 715.91 without a problem but I haven't had experience with the hand. I was thinking....where exactly is the injection? Perhaps because you are coding the 715.94 for the hand they are flagging this as a 20600 for small joint (as in fingers). Is it possible that for the wrist (which would be billable as a 20605) the appropriate Dx would be 715.93 for the forearm?

Just a thought. Otherwise I cannot figure out for the life of me why you would not be getting paid.
Good luck!

Susan

 

[gail]

You could be having a problem because of the 9 in the 4th digit; we use 715.14, which is more specific and is also accurate.