Yes an injection really is a surgical procedure

After explaining this to several patients today it seemed like a good topic to cover.  :)

I know it seems silly, but the CPT codes used for an injection or an aspiration are considered surgical procedures by all insurance carriers.  Injection codes are sometimes referred to as "2" codes, because they all start with the number 2.  

    Example: 20610 for large joint injections like the shoulder or knee...the official description is "Arthrocentesis, aspiration and/or injection; major joint or bursa."

The "2" code is for the injection itself, not the medication.  Medications have a totally separate CPT, usually a "J" code. 

    Example: J0702 is Celestone a type of cortisone...the official description is "Injection, Bethamethasone Acetate and Bethamehasone Sodium Phosphate, per 3 MG." 

What does this mean to you? If you're outpatient surgical benefits all go toward your deductible or co insurance then it's possible that if you have an injection at your doctors office that it won't be covered by your co pay and that you could get a bill later. 

Questions? Comments?

deargabbyinsurance@yahoo.com

Got this question emailed to me shortly after posting the above information...

"Read the blog. A flu shot injection wouldn't be considered surgery would it?"

The short answer is no.  Immunizations are all "9" codes and aren't accompanied (to my knowledge) with an additional medication code like an injection.

   Example: The H1N1 vaccine code is 90470

The long answer is that it is still possible for a vaccine charge to go toward your deductible or co insurance.  Sometimes if an office visit code is accompanied with a vaccine code then the insurance carrier will consider it covered by the office visit co pay...but again every plan is different.