Coding Pediatric Injections For Max Return

Therapeutic and antibiotic injections went through some changes in 2006 and make sure that your medical billing claims reflect those updates or you might be suffering from partial payments or rejections of your medical billing claims.

In the past there were separate injection administration codes for a therapeutic, prophylactic, diagnostic, and antibiotic injections. Instead of choosing to report administration of a prophylactic Synagis treatment (90378) with a 90782 (Therapeutic, prophylactic or diagnostic injection , you now simply use 90772 as a universal injection code. On E/M coding, you will generally still need to attach modifier 25 to insure your claim is handled. Modifier 25 states that this procedure or other service was performed the same day.

If you have a medical billing claim that has been denied, refile your claim using modifier 25 and include the new instructions from CPT to insure that the underwriter making the decision can see you are following the new billing procedures to the letter. Unfortunately, underwriters may not have the most current billing information at their disposal and it’s up to you to make sure that you back up every line on your medical billing claim to show it was necessary and in a logical sequence to ensure proper reimbursements on your filed claims.

View all Articles by: Kathryn E, CCS-P - Retired