Coding Injections and Infusions | Medical Coding Training

Coding Injections and Infusions | Medical Coding Training


Injections and Infusions Medical Coding. Reimbursement
for an E/M service is therefore included in the payment allowance for diagnostic and therapeutic
injections. Injections and infusions – I had some help
with this from Jo-Anne Sheehan. She was going to help us present, we’re actually going
to have her join us regularly to present, but her father-in-law is in the hospital right
now, so that took precedence understandably. So, I’m going to try and go over her answer
sheet she did for us. Q: Hello! My employer wants me to start coding
injections and infusions soon and I want to learn as much as I can. I do have my CPC and
my CCS, but I have not done this yet at the workplace. Is there something CCO offers? A: So, first of all, thanks for thinking of
us first for your educational needs. We don’t really have anything kind of wrapped up, so
hopefully this little segment will help you. And I’ll pull up my answer sheet very thorough
from Jo-Anne. So, what she did is she took things from different sources and kind of
came up with her own little cheat sheet. She did say to really make sure you check with
your top payers that your practice is interfacing with to make sure these guidelines fit. Starting off with Injections and E/M, this
is an area that new coders tend to get a little confused on. So, basically: An E/M service
is an integral component of a diagnostic or therapeutic injection. Reimbursement for an
E/M service is therefore included in the payment allowance for diagnostic and therapeutic injections.
And it goes on, but here in bold: the injection code will be reimbursed unless a significant,
separately identifiable E/M service has been performed. If that’s the case, then modifier-25
should be appended to the E/M code and both the E/M code and injection service will be
reimbursed. So, my little rhyme that I teach during my
coding course for the Blitz is “If you don’t have a HEM (History, Exam, Medical decision
making) you can’t bill an E/M.” So, look at your source document, do you see history
clearly documented, and exam clearly documented and medical decision making clearly documented?
In addition to, in this case, an injection or infusion note; then, you can bill both.
If you don’t, and it’s all just about the injection, then just bill the injection. Now, there are some exceptions, Preventive
Medicine, E/M codes, (99381-99429) include routine services such as the ordering of immunizations
or diagnostic procedures, which are not considered included in the preventive E/M service. Preventive
E/M codes may therefore be reported in conjunction with injection service codes, and modifier-25
is not needed on those. I kind of view modifier -25 as regular E/M
code not like preventive medicine ones. By “regular” I mean, the HEM-based ones (history,
exam, medical decision making), they got those three bullets in them. Then, E/M code with 99211 – 99211 is what’s
referred to as the nurse visit code; it’s that 5-minute quickie code. That will not
be reimbursed when submitted with an injection code. Injections and Medications – Medications provided
at the time of the diagnostic and therapeutic injection should be reported… When I teach
this in the Medicine section, I called it “stick and stuff” and that helped me when
I was new at coding to remember that when you’re talking about injection there’s
normally two pieces to the story: what you’re injecting into the patient and the service
of sticking it to them. So, if that helps, just think “stick and stuff” or what they
call administration and the product. And so, this is just that reminder permission statement
that you can bill for the product separately. Injection & Infusion Services and Supplies
– Standard tubing, syringes, and other supplies are included in the injection or infusion
service code. So, you don’t want to try and bill for them separately and they are
considered incidental. Therefore supply codes submitted with codes for the following services
will not be separately reimbursed when submitted by the same physician or other healthcare
professional… Injection and Infusion Services Include: the
injections themselves, hydration (sometimes they put saline in), therapeutic, prophylactic,
and diagnostic infusions, chemotherapy, and other highly complex drug or highly complex
biologic agent administration. The specific CPT codes associated with the
injections and infusions provide very specific guidelines for initial use and each additional
hour. So, be led by what CPT is telling you for how to code the initial hour and subsequent
ones. And if they’re doing concurrent infusions, it’s all laid out right there in the CPT. The last one: Remember that these guidelines
represent many payers; so it’s always in the best interest of the provider to verify
coverage and coding guidelines for the specific payers that you’re associated with. I normally
recommend calling your top four and making a note of what they say on how to handle that,
and do that for any particular thing that you’re researching that’s popular in your
practice. So, hopefully that will help. I noticed in the chat, two people are asking
about these answer sheets and the slides. For this live free webinar, we don’t provide
it. We will give you links here and there, but for the most part, we’re developing
these answer sheets for our Replay Club members. Our Replay Club is $19.95 a month and you
can cancel it anytime and we provide a full recording of this webinar broken into the
segments, a little video clips of each topic; so it’s real easy to drill down and get
to what you want, and then all these answer sheets that are nice pretty PDF format that,
again, Ruth is an integral part of putting it together.


2 thoughts on “Coding Injections and Infusions | Medical Coding Training

  1. Hi can you plz explain this in a software how we can entered all these in a software like CMD…..practical is much effective to understand….thank you

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