Author Topic: URGENT ! -- J or Q code for xanax ??  (Read 4782 times)

spinalhealth

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URGENT ! -- J or Q code for xanax ??
« on: March 13, 2012, 09:03:02 AM »

We pre-medicate some of our patients before their lumbar injections with xanax - but for the life of me I can't find a J or Q code to bill it !!!!!????  I've looked online, in the cpt book, hcpcs book......nothing!  Does anyone have any info on this; is there a generic code for benzodiazepines??

spinalhealth

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Re: URGENT ! -- J or Q code for xanax ??
« Reply #1 on: March 15, 2012, 04:21:51 PM »
......or has anyone heard of billing code 80154 (even though it's for a drug screening) but using the NDC number on the claim showing we gave the patient the xanax as a pre-med before an injection?

thank you

Michele

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Re: URGENT ! -- J or Q code for xanax ??
« Reply #2 on: March 19, 2012, 05:45:01 AM »
Sorry, not familiar with either.  Can you contact a provider rep for one of the insurance carriers and ask them for assistance?
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PMRNC

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Re: URGENT ! -- J or Q code for xanax ??
« Reply #3 on: March 19, 2012, 10:33:33 AM »
Perhaps you need to look for the generic?  I'm assuming this is an MD? I'm also guessing you need to be careful as benzo's are classified as controlled substances, so I would tred lightly and make sure proper documentation is recorded. With that said I was able to find this which tells me it's not really a medication that will be reimbursed if done via injection:

Q. Would the administration of Xanax or chloral hydrate be reported by the new moderate (conscious) sedation codes?

It would not be appropriate to report the new moderate (conscious) sedation codes for the administration of Xanax or chloral hydrate. The use of drugs to reduce anxiety or tension is not included in or reported by the new moderate sedation codes. Although oral, rectal and intranasal are listed as possible routes of administration (CPT Changes: An Insider's View 2006, page 272), it would be rare that these routes of administration would be used alone to induce moderate sedation. There may be instances, however, in the pediatric population when an oral medication (such as Versed lollipops) may be used as the sole method to induce moderate sedation. In this case, it would be appropriate to report the new moderate sedation codes if all the other CPT requirements for reporting moderate sedation are met, ie, physician in attendance during the intraservice period of sedation and the presence of an independent trained observer.

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Q. When does the intraservice time begin and end for the new moderate (conscious) sedation codes (99143, 99144, 99145, 99148, 99149, and 99150)?

According to the CPT Guidelines, "Intraservice time starts with the administration of the sedating agent(s), requires continuous face-to-face attendance, and ends at the conclusion of personal contact by the physician providing the sedation." The new CPT codes for moderate sedation and the corresponding Relative (Value) Update Committee recommended work values require that the physician be in attendance during the intraservice period of sedation. If a drug is administered to accomplish "moderate sedation," then the time claimed by the physician for the moderate sedation codes submitted must correspond to the documented personal attendance by the physician providing the sedation. Note that a physician cannot order that a drug be given and then leave the patient. For example, a radiologist cannot order a medication be given to induce moderate sedation for an MRI study and then leave the patient with a nurse in attendance to monitor the patient status. This does not meet the requirement of continuous face-to-face attendance by the physician.
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spinalhealth

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Re: URGENT ! -- J or Q code for xanax ??
« Reply #4 on: March 20, 2012, 05:12:19 PM »
we can't locate a code for brand name xanax or generic alprazolam ---- we aren't giving it to the patient as an injection -- when certain patients come in for a lumbar pain injection they are a little on the nervous side, and we have a couple of different medications we may give them to relax them prior to the injection - one of them is xanax.  they are given a xanax in a PILL form, not an injection and that's what we're having difficulty finding a code for.  i'd be happy if i could find a Q code for the oral xanax or a J code for the injection if there is one......