Wiki Out patient professional fee injection coding

[ccadmin]

We are an outpatient clinic setting (Orthopaedic Surgeons) billing for injection CPT code 20605. We as pro-fee (Orthopaedic Surgeons) are billing for it. The facility indicates that they can also bill for the same pro-fee service injection cpt 20605 along with room services E & M. Is that considerated double billing for the CPT code 20605?

 

[mitchellde]

The facility will bill the same 20605 code for the injection to recoup the facility fee. However they have rules for an E&M on the same day as a procedure same as the physician, and if this were a planned injection then they have no basis for a facility E&M.