tci Part B Insider - 2004 Issue 43

Reimbursement: Battle Denials For E/M With Joint Injections

Sometimes carriers decide that they're just not going to pay for a medically necessary evaluation and management service on the same day as another procedure, and you have to fight for reimbursement. That's what orthopedists say has happened recently with joint injections, such as knee joint injections. Carriers have refused to pay for E/M visits on the same day as these injections, even when the doctor performed separately identifiable work.Example: Say a patient visits the physician, who diagnoses the patient's joint pain as arthritis. Then the physician goes ahead and performs a joint injection. The physician should be...

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