Health Information Management

Q&A: Charging for drug administration during urgent care visit

JustCoding News: Outpatient, September 5, 2012

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QUESTION: I work in an urgent care setting and need to know if we can bill an administration code for injection of Toradol. For example, a patient comes in, and the provider performs an E/M and administers 60mg Toradol intramuscular. I have not been charging for it, thinking it’s bundled into the E/M. 

ANSWER: Administration of an injection for nonsteroidal anti-inflammatory drugs, such as Toradol is not included in an E/M. Therefore, you should report CPT® code 96372 (therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular) and HCPCS code J1885 x 4 (Injection, ketorolac tromethamine, per 15mg) in addition to the appropriate E/M level.
 
Editor’s note: Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, Fla., answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, Wis. Email her at ssafian@embarqmail.com.
 
This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.
 
Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC, at mleppert@hcpro.com, and we’ll do our best to get an answer for you.



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