Billing Accurately for Various Orthopedic Injections

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Billing Accurately for Various Orthopedic
Injections
Are you tired of dealing with coding errors and
denied claims for orthopedic injections?
Inaccurate coding for orthopedic injections can
significantly impact your practice's revenue.
Here's how you can master orthopedic billing,
ensuring accuracy and maximizing
reimbursements.  Understanding Basics of
Orthopedic Injection Coding Accurate billing for
orthopedic injections is essential for ensuring
proper compensation for your services. Each type
of injection, whether diagnostic or therapeutic,
comes with specific codes that must be used
correctly to avoid claim denials. Diagnostic
Injections Arthrographies Arthrographies are
diagnostic injections where a contrast dye is
used to visualize the injury, usually followed by
a radiologic examination. Heres how to handle
the coding Wrist Arthrography For wrist
arthrography, you need to bill two codes
together 25246 (for the injection procedure)
and 73115 (for the radiologic examination). These
codes represent a complete procedure, so
additional fluoroscopy codes like 76000 should
not be billed separately.
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Billing Accurately for Various Orthopedic
Injections

• Additional Sites Arthrography codes also vary by
  the anatomical site
• Shoulder 73040
• Elbow 73085
• Hip 73525
• Knee 73580
• Ankle 73615
• For all these procedures, the radiologic exam
  code 73115 should be billed along with the
  injection code.

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Billing Accurately for Various Orthopedic
Injections

• Therapeutic Injections Anesthetics and
  Corticosteroids
• When it comes to therapeutic injections, such as
  injecting anesthetics or corticosteroids, the
  coding rules differ slightly
• Anesthetic Injections If you inject an
  anesthetic like Marcaine into a joint with
  fluoroscopic guidance but without contrast dye,
  use the joint injection code based on the joint
  size and add the fluoroscopy code 76000.
• The codes are as follows
• Small joints (fingers or toes) 20600
• Intermediate joints (elbow, wrist, ankle) 20605
• Major joints (hip, shoulder, knee) 20610
• Corticosteroid Injections For injections
  involving medications like cortisone, use the
  injection code appropriate to the joint size and
  the specific HCPCS code for the medication. For
  cortisone, it is J0810. Ensure to include the
  cost of the medication in your billing.

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Billing Accurately for Various Orthopedic
Injections

• E/M and Injection Billing
• You may bill for an office visit (Evaluation and
  Management, or E/M) in addition to the injection,
  under specific circumstances
• New Problems If a patient presents a new problem
  and an injection is performed after examination
  and discussion, you can bill for the office
  visit.
• For example, use code 99213 with a modifier -25
  (distinctly identifiable E/M service by the same
  physician on the same day of the procedure) along
  with the injection code 20610.
• Follow-Up Visits If the patient returns for a
  follow-up visit specifically for the injection
  after a previously discussed treatment plan, you
  typically only bill for the injectionnot the
  office visit.
• Billing for Additional Services
• Medication Medications such as anesthetics are
  generally included in the injection
  codes 20600, 20605, and 20610. However, if you
  use other medications like cortisone, bill them
  separately using the appropriate HCPCS code.

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Billing Accurately for Various Orthopedic
Injections

• Surgical Trays Some insurance providers allow
  you to bill for the surgical tray (e.g.,
  code 04649) used during the procedure if it is
  performed in-office. Always verify with your
  insurance providers for eligibility.
• 5 Tips for Efficient Orthopedic Billing and
  Coding
• To ensure efficient coding and minimize errors
  in orthopedic billing, here are some key
  strategies
• 1. Implement Electronic Health Record Systems
  (EHRs) Use EHRs to capture detailed patient
  encounter information. This includes examination
  findings, diagnostic tests, and treatment plans,
  which are crucial for accurate coding.
• 2. Establish Coding Cross-Checks and Validation
  Rules Implement coding checks and validation
  rules in your billing software to flag potential
  errors before claims submission. This helps in
  maintaining coding accuracy.
• 3. Integrate Coding Assistants Use coding
  assistants within your EHR systems. These tools
  suggest appropriate codes based on the documented
  information, helping you comply with orthopedic
  coding regulations.

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Billing Accurately for Various Orthopedic
Injections
4. Adopt Machine Learning Applications These can
analyze historical documentation patterns and
highlight areas for improvement, ensuring
your documentation aligns with medical billing
standards. 5. Prioritize Secure Data
Transmission Adhere to Health Insurance
Portability and Accountability Act (HIPAA)
standards to safeguard patient information during
electronic claims submission. Value of
Outsourcing Orthopedic Billing and
Coding Orthopedic practitioners often face
demanding schedules, and the complexities of
orthopedic coding add another layer of challenge.
Outsourcing your orthopedic billing and coding to
experts such as Medical Billers and Coders
(MBC) can be a strategic move. Heres why
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Billing Accurately for Various Orthopedic
Injections

• Cost Efficiency Significant cost savings with a
  potential 10-15 increase in revenue.
• Streamlined Claims Expertise in clean claims
  submission, reducing denials and maximizing
  revenue.
• Optimized Reimbursements Accurate and compliant
  claims through specialized orthopedic coding
  knowledge.
• Take Action Today to Obtain Complete
  Reimbursements for Orthopedic Injections!
• Contact MBC today to discover customized
  solutions for your orthopedic billing needs. Call
  us at 888-357-3226 or email us
  at info_at_medicalbillersandcoders.com to speak
  with our experts.
• FAQs
• Q Can I bill for an office visit when performing
  an injection? 
• A Yes, if the injection is for a new problem
  discussed and agreed upon during the visit. Use
  code 99213 with a modifier -25 alongside the
  injection code.

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Billing Accurately for Various Orthopedic
Injections
Q How often should orthopedic billing codes be
updated? A Orthopedic billing codes should be
reviewed and updated annually to stay compliant
with current regulations and coding
guidelines.  Q How can I ensure compliance with
orthopedic coding guidelines? A Use reputable
sources such as the American Academy of
Orthopaedic Surgeons (AAOS), American Medical
Association (AMA), and the Centers for Medicare
Medicaid Services (CMS) for the latest guidelines
and best practices.