Can You Use 90784 for ED Injections?

Can You Use 90784 for ED Injections?

When performing medical billing for emergency department visits, there are several methods one must follow to ensure full payment. Emergency department injections by a physician and the use of current procedural terminology code 90784 usually brings up many questions.

The medical billing question of when to use CPT code 90784 usually becomes an issue when a hospital supplies an injection or antibiotic to a patient. Many medical billers believe 90874 should not be used in this situation because the physician has not actually purchased the drug, just administered. In all actuality, 90784 means- therapeutic, prophylactic, and diagnostic injections; intravenous. It is totally appropriate to have a medical biller charge for physician professional fees in an emergency department, using this current procedural terminology code.

It is important to note that payers may not allow these services to be billed as physician services. Be prepared for these medical billing claims to be returned and unpaid. To avoid the hassle of getting returned claims with no payment, medical billing companies can assist your practice. When claims get rejected, they will go right to a medical billing company if you choose to outsource that service. These medical billing companies will do absolutely everything in their power to get your claim paid. They will request letters of medical necessity from the attending physician. They will call the insurance company to inquire about the unpaid claim. They will also do follow up until the claim is resolved and paid the correct amount.

The use of CPT code 90784 for emergency department injections and drugs can get fairly sticky between insurance payers and medical billers. To ensure your practice is recovering the most revenue possible, it is beneficial to outsource your medical billing responsibilities to a firm that specializes in those practices.

View all Articles by: Melissa Clark, CCS-P