Lidocaine injections

Every time I think I've got this figured out, I hear that I'm billing this incorrectly.

My doctor uses four different kinds of lidocaine; 1% lidocaine, 2% lidocaine with epi, 1% lidocaine with epi, and Bupivicaine 0.25%. I called the drug rep months ago and was told I needed to use J3490 and put in the description in since there was no code for these. The doctor injects it with a syringe. Most of the claims are rejecting so they are not making it to the insurance. I asked around and one of my co-workers says she uses J2001. The description for J2001 is "injection, lidocaine HCI for intravenous infusion, 10 mg". It is not going in introvenously so I don't think that is correct. Does anyone know the correct way to bill these?

re: Lidocaine injections

Why are you giving this injection and are you administering another drug as well?

re: Lidocaine injections

There are different circumstances. I believe most of the time it is to numb the area for another procedure. (for example, he does testopel pellet inserts)

re: Lidocaine injections

And yes, there are many times where something else is also injected on the same day.

re: Lidocaine injections

Cannot bill anesthetic separately from procedure

re: Lidocaine injections

OK. But, I need to prove this to the doctor with a denial on an EOB. I can't get the claims to go through the clearinghouse because it doesn't like something in the coding.

Just so I understand, you cannot bill for a lidocaine injection when billing another injection? For example, a trigger point injection? In what kinds of situations can you bill for lidocaine injection?

re: Lidocaine injections

The local anesthetic is bundled into the main procedure. This is consistent with CPT® instructions. Intravenous (IV) infusion of lidocaine or ketamine has been used for the treatment of chronic neuropathic pain. Chronic neuropathic pain disorders include phantom limb pain, post-herpetic neuralgia, complex regional pain syndromes, diabetic neuropathy, and pain related to stroke or spinal cord injuries. Intravenous infusion of anesthetics (e.g., ketamine or lidocaine) for the management of chronic pain, including, but not limited to chronic neuropathic pain and fibromyalgia, is considered investigational (Policy of many payers). IV lidocaine is approved systemically by the U.S. Food and Drug Administration (FDA) for the treatment of antiarrythmias.