# Dupuytren's (Palmar Fascia) Injections



## smcdonald (May 20, 2011)

I need help coding an established patient office visit who is having a series of Dupuytren's (Palmar Fascia) Injections code 26989. The patient had the first one on 5/18 and the visit was coded as 99214-25, 26989, J0775. The second visit was the next day 5/19, can someone give me some advise on how to code for the second injection? 

Thx!


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## JHorner (May 20, 2011)

smcdonald said:


> I need help coding an established patient office visit who is having a series of Dupuytren's (Palmar Fascia) Injections code 26989. The patient had the first one on 5/18 and the visit was coded as 99214-25, 26989, J0775. The second visit was the next day 5/19, can someone give me some advise on how to code for the second injection?
> 
> Thx!


If the patient came in specifically for the injection you would only code for the injection and the drug. Have you looked at CPT 20550?


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## twosmek (May 23, 2011)

is this for xiaflex??


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## twosmek (May 23, 2011)

The code sounds like it is for Xiaflex and the info I have from the xiaflex rep is that you should have coded the first injection as follows
99214-25-20550 with J0775 x 90(not with the unlisted 26989--that was to be used before 11/15/2010)
The next day providers are instructed to bill 99213 for the stretching of the cord and 29130 for the splint application. 

I would think that if another injection is given it would be the 20550 and J0775 x 90 only. 

According to the materials I received from xiaflex the injections should be spaced about 4 weeks apart. 

What is the insurance as I know that there are few that are accepting--Medicare is one I know is covering and BlueCross is not covering. Xiaflex has a great program that they will check to see if it is covered for the patient. I would check with the drug rep!!


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## dana.christie@comcast.net (May 30, 2011)

I have a provider who does these on a regular basis and this is how I bill:

Day One:
   20550-injection charge
   J0775 x 90 units for the Xiaflex drug

Day Two:
    26989-manual manipulation to release contracture

You can not bill for an E&M service on either of these days because the first injection is not normally done on the same day as the initial visit.


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