Ask Dr. Z

The patient is having a right shoulder joint injection for a subsequent MRI at an imaging center. Can the physician bill for all of the medications listed, specifically epinephrine, Marcaine, lidocaine, etc.?

"Medication supplies: 13 ml Omnipaque 180, 0.1 ml epinephrine, 5 ml lidocaine, 7 ml bupivacaine, 0.05 ml Gadavist. Discarded: 7 ml Omnipaque 180, 0.9 ml epinephrine, 2 ml lidocaine, 3 ml bupivacaine, 1.95 ml Gadavist.

Lidocaine 1% was used for local anesthetic. Under fluoroscopic guidance, a 27-gauge needle was placed into the right shoulder joint. A small amount of non-ionic contrast was injected into the joint to document intraarticular placement of the needle. A solution of gadolinium, saline, non-ionic contrast, Marcaine, and epinephrine was injected into the right shoulder joint."