Wiki Reference for not billing for lidocaine with triamcinolone in joint injection

[Bernadette10]

Can someone tell me where to find a reference for not charging for lidocaine when injected with triamcinolone into a joint for pain relief? I can't find in CPT or HCPCS where it says this.

 

[daedolos]

Old but I think it's standard policy now that most injections have lidocaine bundled into the other medicine.

Peace
@_*
Hope this helps.



https://www.supercoder.com/coding-n...dles-lidocaine-into-hundreds-of-codes-article

 

[CodingKing]

Its in the CPT book at the beginning of the surgery section, under the heading "Surgical Package Definition:


Second bullet under what is inclusive:


Local infiltration, metacarpal/metatarsal/digital block or topical anesthesia

Also NCCI Manual:

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html (see downloads section for latest manual)

CHAPTER I
GENERAL CORRECT CODING POLICIES

(excrpts)

B. Coding Based on Standards of Medical/Surgical Practice

.........

Many NCCI PTP edits are based on the standards of medical/surgical practice. Services that are integral to another service are component parts of the more comprehensive service. When integral component services have their own HCPCS/CPT codes, NCCI PTP edits place the comprehensive service in column one and the component service in column two. Since a component service integral to a comprehensive service is not separately reportable, the column two code is not separately reportable with the column one code.

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:
- Cleansing, shaving and prepping of skin
- Draping and positioning of patient
- Insertion of intravenous access for medication administration
- Insertion of urinary catheter
- Sedative administration by the physician performing a procedure (see Chapter II, Anesthesia Services)
- Local, topical or regional anesthesia administered by the physician performing the procedure
- Surgical approach including identification of anatomical landmarks, incision, evaluation of the surgical field, debridement of traumatized tissue, lysis of adhesions, and isolation of structures limiting access to the surgical field such as bone, blood vessels, nerve, and muscles including stimulation for identification or monitoring
- Surgical cultures
- Wound irrigation
- Insertion and removal of drains, suction devices, and pumps into same site
- Surgical closure and dressings
- Application, management, and removal of postoperative dressings and analgesic devices (peri-incisional)
- Application of TENS unit
- Institution of Patient Controlled Anesthesia
- Preoperative, intraoperative and postoperative documentation, including photographs, drawings, dictation, or transcription as necessary to document the services provided
- Surgical supplies, except for specific situations where CMS policy permits separate payment

..........

G. Anesthesia Service Included in the Surgical Procedure
Under the CMS Anesthesia Rules, with limited exceptions, Medicare does not allow separate payment for anesthesia services performed by the physician who also furnishes the medical or surgical service. In this case, payment for the anesthesia service is included in the payment for the medical or surgical procedure. For example, separate payment is not allowed for the physician’s performance of local, regional, or most other anesthesia including nerve blocks if the physician also performs the medical or surgical procedure. However, Medicare allows separate reporting for moderate conscious sedation services (CPT codes 99151-99153) when provided by same physician performing a medical or surgical procedure.