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Omnipaque

Lori Posted Wed 23rd of October, 2013 12:45:37 PM

I was reading through the postings and found the one about HCPCS injection coding. And I just wanted to see if I was reading this correctly.

Your answer on the other post was:
The physician’s office may bill the Omnipaque separately assuming the office bears the cost. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM3902.pdf

Whether the bupivacaine is separately payable depends on the payer. Often it isn’t (see CCI manual and CPT surgical section guidelines for the concept of not separately reporting anesthetic with surgery when done by same physician), but check this example: http://www.cgsmedicare.com/ohb/pubs/mb_J15/2013/08_2013/PDFs/OH_2013_08.pdf

It says: “Allowed when billed with 51700, 51720, 62310, 62311, 62318, 62319, 62368, 64400 - 64484, 64505 -64530, 77003, 95990, or 96530. When billed with other procedures, considered part of procedure performed”

So if we did 62311, 77003, J0702 we could add the Q code for Omnipaque if the provider injected Omnipaque to confirm placement?

SuperCoder Answered Thu 24th of October, 2013 07:01:44 AM

We are working on this, please bear with us.

SuperCoder Answered Thu 24th of October, 2013 07:01:44 AM
Mailed to Amit to take it up further as possible.
SuperCoder Answered Fri 25th of October, 2013 16:58:25 PM

Whether you can separately bill Omnipaque depends on 1) the payer and 2) the purpose of the epidural (62311). From the examples you are stating, it looks like some payers will allow you to bill everything separately. I would acknowledge this with you, but also note that it's best to check with the individual payer in this type of situation.

The "includes contrast" in 62311 refers to injection of contrast (so don't code injection separately). That would allow the Omnipaque supply to still be billed separately by a physician who bears the cost of the supply in an office setting.

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