Wiki Spinal Injections

[llhogeland]

I come from a urology background, I am new to a pain management clinic and I am learning the billing for spinal injections. My question is in reference to billing the contrast solution (Omnipaque 240) with interlaminar and transforaminal lumbar and cervical nerve blocks/epidural injections. For example, when billing Cervical Interlaminar 62310 with 77003 for the fluoroscopic guidance and the J1040 for the Depomedrol. Can we also bill the Q9966 for the contrast solution? Does anyone have experience with this? The AAPC Coder does not show any CCI edits so i assumed its billable, but this clinic has never billed it previously so I would assume there is a reason they dont. Would love for someone to shed some light on this for me. Thanks!

 

[C.Lam]

I often come across billing for ambulatory surgery centers (ASC) for spine injections, and the policy is that ASC payments include materials used (drugs and contrast).

It looks like you're billing for the doctor and in a doctor office setting, and I found the following AAOS article useful for your setting:
http://www.aaos.org/news/aaosnow/apr12/managing1.asp

In one of the examples, it does list an office setting example and the drugs, contrasts and Fluoroscope, offered and used by the doctor, billed. Hope this helped.

 

[Melissa Harris CPC]

Are you billing for a physicians office or ASC? I work in a physicians pain management clinic and I do bill for the drugs. However, some of the payors bundle them. I , however, use Q9967 and either Kenalog or Celestone. I would check with the specific payors and make a list of who covers what.

Hope this helps!


Melissa Harris, CPC
The Albany and Saratoga Centers for Pain Management