Proper Use of ED Injection Codes

When to use code 90784 when processing medical billing claims for emergency room injections can raise a lot of questions. If you fail to follow the exact criteria for reimbursements of these types of claims, you risk only receiving partial reimbursement for the services or an outright rejection of the claim.

The question of when to use this code comes up when a hospital supplies an injection or antibiotic to a patient in an emergency department visit situation. 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 and it is completely accurate to use this code that carries a higher reimbursement rate if the patient’s visit meets the criteria for use of this code.

If you’re tired of trying to keep up with the changes in the medical billing industry and you feel like your practice is spending more times chasing codes than servicing patients, it may be time to seriously consider outsourcing your medical billing claims to a third party partner that can handle your billing, make sure you coding and documentation is absolutely accurate and get your practice the maximum reimbursement on your services rendered to patients.

Knowing when to use ED injection codes in the proper medical billing context is just one more reason to outsource your medical billing to the pros that can get your claims paid.

View all Articles by: Melissa Clark, CCS-P