Injections¶
Bursa, Tendon or Other Soft Tissue
Cervical Stellate Ganglion Block
Corticosteroid Muscle, Tendon and Soft Tissue
Epidural Steroid Injection (ESI)
Injections administered by GP/TS
Locally Acting Therapeutic Substance into Other Soft Tissue
Therapeutic substance Temporomandibular Joint
Therapeutic Substance into Joint or Ligament
Trigger (Tender) Point Injection
Injections as Treatments
Injection Codes
04.8 Injection of Anesthetic into Peripheral Nerve¶
This introduction of an analgesic into the sensory portion of a peripheral nerve is for temporary pain relief in the extremities
Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
81.92 Injection of Therapeutic Substance into Joint or Ligament¶
This injection could be an analgesic, a steroid, a vaccination or any other medication into the joint or ligament.
Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
81.92. - Hyalgan injection - Mainly for knee but can be other joints shoulder/hip - usually given as a series of injections { #81.92.6L-Hyalgan_injection-_Inje }¶
Hyalgan is a lubricant similar to the synovial fluid which is injected into a joint, most commonly the knee
A Hyalgan injection is considered an injection of a therapeutic substance and can be located via freeform search using key words 'therapeutic substance' plus the body part (e.g. knee or shoulder or hip), select 'Treatments' and then 'Search'. The medical code in the system is described as 'Injection of therapeutic substance into joint or ligament'.
Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
81.92.6 - Hyaluronic Acid Injection¶
Hyaluronic Acid is also called Hyaluronan. The injection is used to treat osteoarthritis and is given to replace synovial (joint) fluid within the joints. Injections may be done in a series of three to five injections approximately one week apart.
It is considered an injection of a therapeutic substance and can be located via freeform search using the key words 'therapeutic substance’ plus the body part (e.g. knee or shoulder), select 'Treatments' and then 'Search'. The medical code in the system is described as “Injection of therapeutic substance into joint or ligament”. __Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
83.98.1 Injection into Bursa, Tendon or Other Soft Tissue¶
This injection could be an analgesic or other medication into the bursa, tendon or soft tissue Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
83.98.2 Trigger (Tender) Point Injection { #83.98.2_Trigger(Tender\ }¶
This is an injection of anesthetic into a trigger point to relieve muscle spasm. Multiple injections to the same body part on the same day only counts as one injection; Visits captures number of days treated, not number of injections; if the neck, back and shoulder all receive TPI only one injection is entered for each body part/area Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
83.98. A/B/C/E/F Injection of Locally Acting Therapeutic Substance into Other Soft Tissue¶
Can be an analgesic, a steroid, or any other medication injected into soft tissue, includes Botox injections when used in the treatment of neck and back pain Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
Hard to find injections:
* **83.98.B4B \- Sciatic Nerve Block**
* **83.98.B4B \- Nerve Root Block**
* **83.98.B4B \- Botox neck/back**
* **83.98.B4B \- SI (Sacroiliac Joint Injection)**
* **83.98.A9 \- Occipital Nerve Block**
99.23 Injection of Corticosteroid in Muscle, Tendon and Soft Tissue¶
Introduction of a steroid into the muscle, tendon, bursa or soft tissue to decrease inflammation and pain
Common trade/generic names of corticosteroids:
Celestone, Decadron (dexamethasone), Aristocort (triamcinolone), Prelone (prednisolone) and Depo-Medrol (methylprednisolone) - Use of local anesthetics such as Xylocaine and Marcaine are included in the injection code and not coded separately
Entered with First/Last Dates - (Bulk Entry: Include # of Visits, Not # of Injections)
99.19 Injection of heparin or other anticoagulant¶
Injection of anticoagulant, which thins the blood, in order to prevent blood clots from forming.
Coumadin is an anticoagulant and is entered using 99.19
Entered by Single Medical Occurrence Date
03.91 Facet Joint Block¶
Injection of an analgesic for temporary pain relief, or corticosteroid to reduce inflammation, of the nerves that exit the facet joints of the vertebra; used to decrease pain radiating into the extremities (radiculitis) Entered by Single Medical Occurrence Date
Use of a fluoroscope is included in the code; for multiple injections to one area enter code one time per date.
Also referred to as :
· Paravertebral Nerve Block
· Cervical Nerve Block
· Cervical Branch Nerve Block
· Zygapophysial Joint Block
03.91 Medial Branch Block¶
Medial Branch Block is very similar to the facet joint block. Medical branch refers to small nerve branches that supply sensation to the facet joints. It can also serve as a diagnostic in order to determine if additional treatment, such as radiofrequency lesioning, will be needed.
In the system, a medial branch block/injection is entered as a ‘facet joint block’. The root code is 03.91 and there is a code for each region of the spine. Entered using a Single Medical Occurrence Date; this means that for each injection received to each region of the spine on a specific date a single entry is made. If there are multiple blocks/injections to one region of the spine during a single visit the code is only entered one time.
03.92 Epidural Steroid Injection (ESI) { #03.92_Epidural_Steroid_Injection(E }¶
Medication injection into the epidural space of the spinal canal to treat swelling, pain and inflammation associated with conditions involving nerve root irritation such as herniated discs; use of a fluoroscope is included in the code. Entered using a Single Medical Occurrence Date; this means that for each injection received to each region of the spine on a specific date a single entry is made
03.92 Interlaminar Spinal Injection¶
The term refers to the space which separates the lamia. An Interlaminar injection is a type of epidural steroid injection where the epidural space is accessed through the ‘Interlaminar region’ of the spine.
· An Interlaminar injection or selective Interlaminar injection is entered in the system utilizing the treatment code “Epidural injection of steroid into spinal canal’
· The root code is 03.92
05.3 Sympathetic Nerve Injection¶
Related to the sympathetic nervous system (rather than peripheral nerves) that control involuntary muscle contraction (stomach, heart, lungs) and generalized pain response.
Injections into a sympathetic nerve include injecting an analgesic or anesthetic or an agent that is destructive to the nerve (neurolytic agent). The injection may be referred to as a Sympathetic Nerve Block or Stellate Ganglion Block.
Entered using a Single Medical Occurrence Date; this means that for each injection received to each region of the spine on a specific date a single entry is made
05.31 Cervical Stellate Ganglion Block¶
The stellate ganglion is a group of nerves in the sympathetic nerve chain located in the neck/cervical area, especially at the C-7 level just below the subclavian artery.
· In the system, the treatment code for stellate ganglion block is described as ‘Injection of anesthetic into sympathetic nerve for analgesia-cervical’
· The root code is 05.31
05.31 and 05.39 are anesthetic relief only (Temporary)
05.32 actually destroys the nerve fiber (Permanent)¶
· 05.31 is used when injection of anesthetic is given around nerves
· 05.39 is used for other injection into the nerves or ganglion
· 05.32 is used for injection of Neurolytic agent
83.98, 83.98.1 or 83.97 Prolotherapy Injection¶
Prolotherapy, also known as nonsurgical ligament reconstruction, is a type of therapy used in the treatment of chronic pain. It is most often
associated with soft tissue neck and back injuries (sprain/strain), fibromyalgia and herniated discs. A sugar water solution is injected into a ligament or tendon. This results in localized inflammation in the area and subsequently increases the blood supply and flow of nutrients to the area which in turn helps to stimulate repair of the tissue.
· In the system, Prolotherapy can be entered using one of the following injections codes:
o 83.98 – Injection of locally acting therapeutic substance into other soft tissue
o 83.98.1 – Injection into bursa, tendon or other soft tissue
o 83.97 – Injection of therapeutic substance into tendon
76.96 Injection of therapeutic substance into temporomandibular joint.¶
A therapeutic substance is any substance with healing properties; e.g., corticosteroids. This code may be used for any injection into the joint; it may be done to relieve symptoms of TMJ, reduce bite or some other abnormality with joint function. Entered by Single Medical Occurrence¶
IV Treatment Codes¶
· 99.15, 99.18 and 99.29 can be used when IV treatment is administered in conjunction with a single ER visit or as part of an inpatient hospital stay.
· The appropriate code should be selected based on what the medical records indicate in relation to the type of IV treatment received.
· IV treatment is entered with a single medical occurrence date, which should be the date of treatment
· the system does not currently have the functionality to capture the duration of IV treatment for inpatient hospitalization
99.15 IV (Intravenous) Feeding { #99.15_IV(Intravenous\ }¶
The introduction of fluids through a vein
99.18 Electrolytes Infusion¶
Introduction of fluids and chemicals through a vein
99.29 Intravenous infusion of fluids, antibiotics, anticoagulants or other medications¶
Used when pain medication, antibiotics or other medications is given intravenously
99.38 Administration of Tetanus Toxoid¶
Injection is given for open wounds, penetrating injuries and open fractures. If the individual has been previously immunized only a booster shot will be necessary otherwise a series of vaccinations are necessary.
99.44 Rabies Vaccination¶
Injection/vaccination given to individuals bitten by animals suspected to be rabid to prevent rabies from developing. The vaccination involves five (5) injections which are usually given in the upper arm.
Entry of the code includes five (5) injections so there is no need to enter the code more than once.
Injections for general pain relief¶
Pain Injections, such as morphine, for 'all over pain' or 'generalized pain' are not captured in the system
Injections administered by GP/TS¶
When a Trigger point injection or any other type of injection is given to the cervical (neck) or lumbar (back) area by a GP/TS and the claimant has been diagnosed with a cervical and/or lumbar sprain, entry of an office visit in addition to the injection is only necessary when an exam actually took place. If the injection is the only form of treatment received from the GP/TS, you do not need to enter an office visit.
Injections as Treatments¶
99.03 Blood transfusion¶
99.07 Plasma transfusion¶
Tips¶
· “inj” is the Freeform abbreviation for “injury”, not “injection”
· www.drugs.com/cons/oradexon.html provides a list of names for corticosteroids