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Ask-A-Consultant: J2000 replacement code for injection of Lidocaine

Q:

We recently found that J2000 has been deleted. What should you use for the injection of Lidocaine?    The replacement code is for IV only and we do not use IV form in this procedure.    This is just one drug that is used in a procedure we call a bladder cocktail.

A:

If your "bladder cocktail" refers to a mixture of drugs used for an anesthetic during a bladder irrigation, lavage or instillation of a therapeutic substance, then the lidocaine component does not appear to be covered. The HCPCS codes are primarily maintained by the Center for Medicare & Medicaid Services (CMS), therefore, the use and maintenance of the HCPCS coding database depends on CMS's definition and usage.

The bundling rules for surgery appear to have been clarified to bundle a lidocaine injection for a local anesthetic into the surgical tray supplies bundled into the surgical procedure code.

The Medicare Part B Carrier for Georgia states that the description of the old J2000 code is dosage that is specific to the treatment of cardiac arrhythmias and emergencies only. The billing of J2000 was not appropriate for the 1-2 cc usually required for a local anesthetic.

Per Medicare, Lidocaine will be covered when administered in the office setting for the treatment of ventricular arrhythmia's. This must be supported with documentation.

Therefore, the code J2000, historically used for a local anesthetic has been deleted and the replacement code J2001 was added to make it clear that it was for 10mg administered by IV.
 

Karen M. Beard, CPC
Senior Associate

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