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Marcaine code

Mike Posted Wed 08th of July, 2015 20:21:15 PM

Patient had trigger point injections and was given 1mL 0.5% Marcaine. Would the code be S0020 and 1 unit for a commercial carrier?

SuperCoder Answered Thu 09th of July, 2015 00:44:11 AM

Yes, for commercial carrier, bill HCPCS code S0020.

Mike Posted Thu 09th of July, 2015 16:23:40 PM

this was a 10X10mL vial not a 30mL vial- so would it bee the same code--S0020?

SuperCoder Answered Fri 10th of July, 2015 00:24:21 AM

You should bill 1 unit of HCPCS code S0020. CMS clearly states that "If the full dosage provided is less than the dosage for the HCPCS code descriptor specifying the minimum dosage for the drug, the provider reports one unit of the HCPCS code for the minimum dosage amount." Do not forget to mention that drug left over was discarded. For detailed information, read the "Chapter 17 - Drugs and Biologicals" of Medicare Claims Processing Manual at link: http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs.html

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