tci ED Coding & Reimbursement Alert - 2004 Issue 6

Reader Question: Physician Involvement Can Add E/M Code to Injection Claim

Question: When the physician performs an intramuscular injection, are there any situations in which I could report 90782 for the injection and also a separate evaluation and management service? Arizona Subscriber Answer: Medicare will pay for 90782 (Therapeutic, prophylactic or diagnostic injection [specify material injected]; subcutaneous or intramuscular) if your physician performed no other service payable under the Physician Fee Schedule during that patient encounter. If the physician provided additional services, such as an evaluation for wheezing, Medicare will consider 90782 bundled into the appropriate E/M code from the 99281-99285 code set (Emergency department visit for the evaluation and...

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